Citizen Complaint Illicit Discharge Reporting Form

Please use this form to report pollution that does not require immediate attention. A staff member will respond during business hours. If the situation requires immediate attention, please call our Environmental & Technical Division at 503-856-3444. For after hours spills that require immediate attention, please call 503-393-1608 to reach our on-call staff.

*Would you like our staff to follow up with you after the investigation?

If yes, please enter your name and contact information.

*First Name

Last Name

Email Address

Phone

*Please describe the problem. If you can describe the material, color, odor and source of pollution.

*Where is the problem? (Provide an address, nearest intersection, or a description of the location.)

*Did the pollution enter a waterway?

*Did the pollution enter a storm/street drain?

Please share any photos or videos of the pollution. This will help us identify the source and severity of the problem.

Please include any additional information you think will be helpful.

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City of Keizer, Oregon

City Hall
930 Chemawa Rd NE
Keizer, OR 97303
Phone (503) 390-3700

Monday through Friday
8:00 a.m. to 5:00 p.m.
(excluding holidays)

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