Complaint Form

Report a Complaint Online

State Form 57061 (1-21)

Please Note: If you need to report an environmental emergency or a spill, please contact us via IDEM's 24-hour Emergency Spill Line toll free at (888) 233-7745 or (317) 233-7745.

When filing a complaint, please provide as much detail as possible about the location of the complaint, when the activity occurred, and what happened.

Note: Providing your contact information under the General Information section below will allow IDEM staff to contact you for any additional information they need. It will also allow us to contact you with the findings from the complaint investigation.

About anonymous complaints: Any contact information submitted on this form, including name and address, becomes part of the public record and may be subject to public disclosure, upon request. Individuals who wish to remain anonymous should click the Anonymous radio button, which will blank out the fields for name, address, telephone number and e-mail address.

* Yellow items are required

Personal Information Are you an:

Individual

Public Official

Anonymous

Name:

Street Address:

State:

City:

ZIP:

Telephone:

Secondary Telephone:

Email Address:

Tell Us About Your Complaint Is your complaint about:

Pollution

IDEM

Who do you think is responsible for the activity?

Owner/Company Name:

Street Address:

State:

County:

City:

ZIP:

Telephone:

What is your complaint? How are you aware of it? Have you talked with anybody else about it? If yes, please provide details of what was discussed

Please provide driving directions to the location of the complaint

Where does this activity specifically occur (e.g., in the back of the green building; on the southwest corner of the property; in the parts washing rooms)?

When did it occur?

What time did this occur?

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