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Environmental Complaint Form

Environmental Complaint Feedback Form

Their Information - Who is causing the violation and where is it occurring? Do NOT put your information here!
Responsible Party Name: * (Put Unknown if you do not know)
Address: * (or Parcel # if no address)
City: *
Zip: *
Major Cross Streets: (Near Violation Location)
Description: (Please give details of complaint)
Location Description: (Where on property?)
Is The Property Accessible? (Gated, Fenced, Dogs, Posted No Trespassing):
Date & Time of Occurrence:
You may submit photos by mail, electronically, or in person. To mail photo(s), send them to PDEQ, 33 N. Stone Ave., Tucson AZ 85701, attention Complaint Coordinator. To deliver photos in person, please come to PDEQ’s office located in the Bank of America Building at 33 N. Stone Ave., Tucson, 7th Floor between 8am and 5pm, Monday through Friday. To submit photos electronically, please check the box below and provide your email address or telephone number. A PDEQ representative will contact you with an email address where you can send the photo(s). NOTE: By providing your email address/telephone number, this information will be part of the public record. You may call PDEQ directly at (520) 724-7400, if you wish to remain anonymous and not provide contact information.
I have an attachment, please contact me.	Email or Phone:

Your Information - This is You!
(required if you want a reply - optional if you want to remain anonymous) (Be advised: all complaints become public record and are subject to dissemination upon request)
Complainant: (your name)		Email Address:
Address:		Phone #1:
City:		Phone #2:
Zip:		Pager:

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Department of Environmental Quality

33 N. Stone Ave., Suite 700
Tucson, AZ 85701

Phone: (520) 724-7400
Fax: (520) 838-7432