Reporting Pollution · EPA Interaction Portal

Pollution Type

Source / Receptor

Type

Chosen Alleged Location Payload

First Name

Last Name

Contact Number

Address

I wish to remain anonymous

Chosen Location Payload

Pollution Source Location

Issue Still Occurring

When did the pollution start?

When did the pollution end?

What is the frequency of the pollution?

Do you have any Health Concerns/ Fears?

Provide details of your health concerns / fears

Has your health been impacted?

Provide additional details regarding how your health is impacted

Is this a new or ongoing issue?

What is making the noise?

Please advise what is making the noise

Select an option that best describes the noise

Please provide details that describe the noise

How is this pollution impacting you?

Where do you believe the pollution is coming from?

What was the date and time you experienced this pollution?

Have you experienced this before?

Please describe the scale of pollution by stating a number between 1 & 10, with 10 being the worst

If you can determine the wind direction, please state the direction

Is this an ongoing issue?

If our officers need to contact you for further information, are you willing to assist?

Would you like to be notified of the outcome of your report?

Do you consent for your details to be passed onto other government agencies if required?

Pollution Description

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Enviro Segment / Waste

Pollutant

Scale