Citizen Reporting
Name (Optional):
Contact info (E-mail or Phone):
Date/Time of Observation: *
MM
/
DD
/
YYYY
Time
:
Weather and environmental information: *
Name of stream or creek: *
Location of observation (please identify as close as possible using GPS, streets, address, trail, or other information): *
Condition of creek water (clear, muddy, foaming, etc):
Short description of the creek bank and immediate area (i.e. no vegetation, loose dirt, lawn, park, adjacent to residential back yards, light industrial or business area):
Type of observation:
Culvert or pipe problem (broken, hanging, exposed thaw wires, crushed, etc.):
Garbage or debris:
Polluting agent (i.e. oil):
Other Information:
Additional Comments:
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