1

Your Information

Your Information

Your Name (confidential)

Your Phone (only used if necessary)

2

Water Waste Information

 *

Water Waste Information

Street Address where water waste is occurring

Business Name (if applicable)

3

Type/description of waste: (check all that apply)

Type/description of waste: (check all that apply)

Wasting water, which includes but is not limited to, the flooding or runoff on City sidewalks, gutters, and streets.

Cleaning of sidewalks, driveways, patios, parking lots, or other paved or hard-surfaces areas, or washing cars, buses, boats, trailers, or any vehicle by use of a hose unless that hose is fitted with an operating automatic shut-off valve.

Water waste due to broken or defective plumbing, fire system, irrigations system, or any appurtenance thereto; or to open or to leave open any stopcock or faucet so as to permit water waste.

Service of water from any restaurant unless requested by a patron.

Installation of a non-recirculating decorative fountain.

4

Location description of waste on property

Location description of waste on property

5

Time of day waste occurs

Time of day waste occurs

6

Phone of property owner: (if known)

Phone of property owner: (if known)

7

Name of property owner: (if known)

Name of property owner: (if known)

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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