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Illicit Discharge - Illegal Dumping - Stormwater Complaint Form

  1. Illicit Discharge - Illegal Dumping - Stormwater Complaint Form

    Please report emergency violations to the Madison County Property Code Enforcement Department at 731-423-2041.

  2. Confidentiality Statement

    Any and all information submitted, will remain confidential about the identity of the individual completing this form.

  3. Asterisk (*)

    Any field marked with a red asterisk is required and must be completed to submit this form.

  4. Contact Information For Individual Submitting Form

  5. Violation Information

  6. Illicit Discharges May Include; But Not Limited Too: Sewage, Debris, Chemical Disposal, Industrial Waste, Oil Disposal and/or Similar Discharges.

  7. Please be as descriptive as possible about any vehicles, license plates numbers, individuals and/or violation activity witnessed.

  8. Leave This Blank:

  9. This field is not part of the form submission.