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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.).

    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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27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

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