ADEQ: Compliance: File a Complaint

Arizona Department of Environmental Quality


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COMPLIANCE: FILE A COMPLAINT

Please use this page of our Web site to file a formal complaint or to report a suspected violation of environmental law or rule. ADEQ compliance officers will use the information below to follow up on the complaint.

Complaint Information
Note: fields with a * are required.

Site/Operator/Source name:		Site address:
Site phone:		Type of operation:
Major cross streets:		*Nearest city:
*County:		Description of documents verifying occurrence (photos, video, etc.):
Date of occurrence: (i.e., 04/11/2007)		Time of occurrence:
Substance involved in occurrence:		Estimated quantity of substance involved:
Best time to witness occurrence (if ongoing):		*Environmental medium most affected:
*Description of complaint: Characters Remaining: 2000

Your Information
Note: fields with "*" are required.

*Your name (first, last):		*Address:
*City:		*State:
*Zip:		E-mail:
*Phone:
Have you been referred to ADEQ?: Yes No		If yes, by whom:

*Would you like to be contacted about the result of your complaint?: Yes No
Arizona law requires you to provide your name during the course of reporting an alleged violation of law or rule. Under the law, your name will be placed in the public file unless the release of your name may result in substantial harm to any person, including yourself, or to the public health or safety. See A.R.S. § 41-1010.

*Do you feel that the release of your name may result in substantial harm to any person, including yourself, or to the public health or safety?: Yes No If yes, please describe:

Press Submit once only! or you will send multiple entries to us.

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| Web Site Services | Last Revision Oct. 26, 2007
Any ADEQ translation or communication is unofficial and not binding on the State of Arizona.
Cualquier traducción o comunicación de ADEQ no es oficial y no sujetará a ninguna responsabilidad legal al estado de Arizona.