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Pollution Reporting Form

2. POLLUTION REPORTING FORM
4. Thank you for taking the time to report a pollution incident. the City of Hartford will follow up with appropriate action. This is a non-emergency reporting form. For an emergency situation, such as an oil, fuel or hazardous chemical spill please also call the DNR's hotline at (800) 943-0003. If a safety hazard exists, please call 911.
6. First Name
7. Last Name
9. Email Address
11. Date & Time of Incident
    Date & Time of Incident

    Date & Time of Incident
13. Location of Pollution
15. Report what you saw
17. Do you want the city to call you?*

    1. Yes
    2. No
19. Please provide your phone number
Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

* indicates a required field