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
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:


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

    This field is not part of the form submission.

28. Submit

* indicates a required field