Stormwater Pollution Complaint Form

2. If you are experiencing a stormwater issue, or have observed pollution in our local waterways recently, we would like to hear from you. Pollution can be any type of trash or harmful chemicals that are dangerous to people and the environment. Pollutants can enter our waterways through the storm drain system. Dumping pollutants in the gutter or into a storm drain is illegal.
   Please complete this form as completely as possible, and click on [Submit] to forward the form to the Shelby County Stormwater Engineer

   Please complete this form as completely as possible, and click on [Submit] to forward the form to the Shelby County Stormwater Engineer

4. Date(s) issue was Observed*
   Date(s) issue was Observed

5. Optional
   Optional

7. Location issue was observed*

9. Name of person(s) or company involved (if known)

11. Vehicle License Plate

12. Location Telephone Number

14. Other Contact Information

16. Please Describe the Stormwater or Pollution Issue*

18. Your contact information (Optional):

20. First Name

21. Last Name

23. Daytime telephone number

24. Email

Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field