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Illicit Connection/Discharge Report Form

  1. Discharge Site:*

  2. Dumping/Spill (hazardous/toxic materials or sewage) into Storm Drain

  3. Non-Stormwater Discharge (Suspected or Actual Illicit Discharge)

  4. Illicit Connection (Actual or Possible)

  5. Illicit Discharge Color

  6. Material(s) that Parially or Wholly Make-up the Discharge

  7. Leave This Blank:

  8. This field is not part of the form submission.