What information does the Illicit Discharge Reporting Form request?

It requests contact information, the discharge location, discovery and rain-event details, and observations such as flow, odor, color, clarity, and visible materials.

Do I need a notary for the Illicit Discharge Reporting Form?

No. This form is signed and dated without a notary. Attach a copy of any photo taken; a chain-of-custody record is requested only if a laboratory sample was collected.

Southmont, PA · Cambria County

No notary required

Illicit Discharge Reporting Form

This form lets residents report a suspected illicit discharge by providing contact details, the location, and observations about the discharge.

What this form is

Use this form to report a suspected illicit discharge and provide information that can assist an investigation. It asks for your contact details, when and where the discharge was found, and observations such as water flow, odor, color, and visible materials. The form also includes a section for follow-up investigation by CCD staff.

Who needs it

Residents who discover a suspected illicit discharge can use this form to share its location and details with the city.

How to submit it

Submit it to the city department named on the form; check the city website for current contact details.

About notarization

This form is signed and dated without a notary; attach a copy of any photo taken, and a chain-of-custody record only if a laboratory sample was collected.

How to submit this form

1
Download the Form
Download the Illicit Discharge Reporting Form.
2
Complete the Report
Enter your contact details, the discharge location, and what you observed.
3
Gather Attachments
Attach a copy of any photo taken. Include a chain-of-custody record only if a laboratory sample was collected.
4
Submit to the City
Submit it to the city department named on the form; check the city website for current contact details.

Frequently asked questions

What information does the Illicit Discharge Reporting Form request?: It requests contact information, the discharge location, discovery and rain-event details, and observations such as flow, odor, color, clarity, and visible materials.
Do I need a notary for the Illicit Discharge Reporting Form?: No. This form is signed and dated without a notary. Attach a copy of any photo taken; a chain-of-custody record is requested only if a laboratory sample was collected.
How do I submit the Illicit Discharge Reporting Form?: Submit it to the city department named on the form; check the city website for current contact details.

Need something notarized?

This Illicit Discharge Reporting Form doesn’t need a notary — but if you have another Southmont form that does, a commissioned online notary can help.