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Report-a-Polluter

2. First Name*
3. Last Name*
5. Email*
6. Phone
8. Address
10. City
11. State
12. Zip
14. Description of Discharge
16. When It Occurred
    When It Occurred

    When It Occurred
18. Address of Discharge
20. City
21. State
22. Zip
24. Additional Comments
    Identity of polluter if known, has this happened before, etc.
26. Disclaimer
    Report-a-Polluter Complaints within the Hamilton County jurisdiction will be assigned to a staff member of the Hamilton County Surveyor’s Office. Please be prepared to be contacted if additional information is needed. If the pollution location lies outside the jurisdiction of Hamilton County our office will forward your complaint to the appropriate municipal jurisdiction (ie: Cicero, Fishers, Noblesville, Westfield, Arcadia or Carmel) or other appropriate government agency (IDEM, Emergency Management, etc.).
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28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

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