What is the Citizen Complaint Illicit Discharge Reporting Form?

It is a form for reporting a suspected illicit discharge. It collects contact details, the discharge location, and observations such as water flow, odor, color, and clarity.

Who can use this form?

A resident who discovers a suspected discharge can use the form to provide information that may assist an investigation. It includes separate follow-up fields for CCD staff.

Pen Argyl, PA · Northampton County

No notary required

Citizen Complaint Illicit Discharge Reporting Form

Residents use this form to report a suspected illicit discharge and provide information that may help city staff investigate the incident.

What this form is

This form lets a resident report a suspected illicit discharge and provide details to support an investigation. It asks for contact information, when and where the discharge was found, observed water flow, odor, color, clarity, and other signs; it also includes fields for follow-up investigation by CCD staff. The form requests a photo attachment if one was taken.

Who needs it

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

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 does not require a notary; it asks for the complainant’s name and date, while CCD staff sign and date the follow-up data sheet.

How to submit this form

1
Download The Form
Download the Citizen Complaint Illicit Discharge Reporting Form.
2
Complete The Report
Enter your contact information, the discharge location, and the requested details about what you observed.
3
Gather Any Photo
If you took a photo, attach a copy to the form.
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 is the Citizen Complaint Illicit Discharge Reporting Form?: It is a form for reporting a suspected illicit discharge. It collects contact details, the discharge location, and observations such as water flow, odor, color, and clarity.
Who can use this form?: A resident who discovers a suspected discharge can use the form to provide information that may assist an investigation. It includes separate follow-up fields for CCD staff.
Do I need a notary for the Citizen Complaint Illicit Discharge Reporting Form?: No. The form does not require a notary; it asks for the complainant’s name and date, while CCD staff sign and date the follow-up data sheet.
How do I submit the form?: 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 Pen Argyl form that does, a commissioned online notary can help.