Mountville, PA · Lancaster County

No notary required

Citizen Complaint Illicit Discharge Reporting Form

Residents use this form to report a suspected illicit discharge and provide details that can help Mountville municipal staff investigate.

What this form is

This form records a citizen complaint about a suspected illicit discharge and gives municipal staff information for a follow-up investigation. The reporter provides contact details, when and where the discharge was found, and observations such as water flow, odor, color, and clarity; the form also asks for additional information and a photo if one was taken.

Who needs it

Residents who discover a suspected illicit discharge can use this form to report its location and details to Mountville.

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 has no notary block; the reporter provides a name and date, and should attach a photo if one was taken.

How to submit this form

  1. 1

    Download The Form

    Download the Citizen Complaint Illicit Discharge Reporting Form.

  2. 2

    Complete The Report

    Enter your contact information, the discovery date and time, the discharge location, and your observations.

  3. 3

    Attach A Photo

    If you took a photo, attach a copy to the form.

  4. 4

    Submit To The City

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

Frequently asked questions

What does the Mountville illicit discharge form report?
It records the discharge location, discovery time, water observations, and other details to help municipal staff investigate a citizen complaint.
Who can use the Citizen Complaint Illicit Discharge Reporting Form?
Residents who discover a suspected illicit discharge can provide their contact information and observations using this reporting form.
Do I need a notary for the Mountville illicit discharge form?
No. The form has no notary block; the reporter provides a name and date, and should attach a photo if one was taken.
How do I submit the Mountville illicit discharge form?
The document does not give submission instructions. Submit it to the city department named on the form; check the city website for current contact details.

Need something notarized?

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