South District Citizen Concern Form

Report any Petroleum or Chemical Spills to the State Watch Office at 1-800-320-0519

Report Spills in Surface Water & Sunken Vessels causing sheens to: National Response Center at 1-800-424-8802

To report algal blooms, fish kills or red tide, visit the DEP Algal Bloom Monitoring and Response website.

NOTE: If the concern is in regards with the Zemel Road Odor Complaint, please fill out the Zemel Road Odor Complaint online submission form.

2. Address or location where the concern is occurring (if unknown, provide cross streets) *This question is required.

3. Please choose one or more categories for your concern: *This question is required.

State Lands
Storage tanks
Storm water
Surface water
Wastewater/Sewer Systems
Wetlands
Other - Write In (Required) Please enter an 'other' value for this selection. * This question is required.

4. Date observed *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

5. Please provide a description of your concern. Fill in the following with as much information as you have available. Any details you provide will allow us to better serve you and provide resolution to the issue. *This question is required.

6. Do you have any files, document or pictures to submit? *This question is required.

Attach any documents or photographs or video you would like to submit as evidence (optional)
Max upload size per file is 500k. You can submit up to 10 files.
(png, gif, jpg, doc, xls, docx, xlsx, pdf, txt, mov, mp3, mp4) *This question is required.

File: {{filename}} delete

Please fill in the remainder of the questions with your personal details. This will allow us to contact you for further information if necessary and to provide status updates. If you wish to remain anonymous, please skip to the end and submit your concern. However, in some cases, not being able to contact you may limit our ability to investigate the problem.

Please note, if you choose to enter your contact info, you will not be able to remain anonymous due to Florida public records law.

Name

Phone Number

Email Address This question requires a valid email address.

Preferred Method of Contact

Would you like to be contacted with status updates?