Environmental Violation Report

You may make this complaint anonymously. If you wish to be anonymous, do not include your name or any contact information. If you include your name or any contact information it will become a part of the public record. Please be aware that complaints – including complainant identification - are public records and thus can be obtained by any member of the public.

Please complete this form and submit it, and/or use it as a guide and call us directly at 802-828-1254.

Whichever way you choose to report, it is important that you supply us with all the known facts to answer the questions on the form. Doing so allows us to respond in the most appropriate manner to minimize any harm to human health or the environment and, when appropriate, take enforcement actions against those responsible.

If you would like to know the outcome of a previously reported complaint, call us at 802-828-1254.

Please do not report the same complaint multiple times.

Date or time period violation first observed:

Date or time period violation last observed:

Town where violation occurred:

Description of violation:

Address of subject site

Directions to subject site:

SPAN # of subject site:

Name of the violator(s), if known:

Mailing Address of the violator(s), if known:

Contact Information for the violator(s), if known:

Your name: (Do not fill out if you wish to remain anonymous)

Your mailing address: (Do not fill out if you wish to remain anonymous)

Your phone number: (Do not fill out if you wish to remain anonymous)

Your email address: (Do not fill out if you wish to remain anonymous)

If you know of any other witnesses, please provide their name(s) and contact information:

Enter any other information/comments here:

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