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Report Illegal Dumping Form

Please fill out the form as completely as possible. It is the policy of the City of Seattle to keep the identification of reporters confidential, pursuant to the privilege within the Washington Public Information Act.

* Indicates required fields. Information is only used for follow-up on the report.

Contact Information:

Name*
Street Address*
Zip Code
Day Phone (with area code) *    ext.
Alternate Phone (with area code)    ext.
E-mail

Illegal Dumping violation information:

Location of Illegal Dumping Violation: *

Address:
Number * Prefix Street Name * Street Type Suffix
 -- Or -- 
Intersection:
Street Name * Street Name * Corner *
/
Specific Location*
Planting Strip Median
Sidewalk Right of Way (50 char limit)
Alley Other (please describe)
Greenbelt Vacant Lot
Description of Illegal Dumping: (select all that apply)*
Furniture Construction Debris
Appliance Yard Waste (50 char limit)
Electronics Other (please describe)
Auto Parts Hazmat (paints, solvents, other unidentified liquids)
Tires TV/Computer Monitor
Garbage Litter

Comments:
This space is for your comments, further description of materials dumped, and any other additional information which may be of help to our inspectors. (150 char limit)

Submit Form:


Privacy Information:
The information on this form will be sent in an unsecure transmission and could possibly be monitored. If you have an unlisted phone number or other information you do not wish to release via e-mail, please telephone your report to (206) 684-7587. It is the policy of the City of Seattle to keep the identification of reporters confidential, pursuant to the privilege within the Washington Public Information Act.
700 Fifth Avenue, Suite 4900 Seattle, WA 98104-5020    (206) 684-3000
©2007 Seattle Public Utilities