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2. This form is for reporting suspicious discharge, trash or debris in storm drains, illegal dumping down a storm drain, in a ditch, etc.
4. Reporting Contacts Information
6. **All reports made to the City of Texarkana, Texas Stormwater Management will be kept confidential**
8. First Name*
9. Last Name*
11. Address1
13. Address2
15. City
16. State
17. Zip
19. Phone Number*
20. Email Address
22. Complaint Information
24. Location Address or Intersection*
26. Description of Complaint*
    Please provide as much detail regarding the issue as possible. This could be license plate of vehicle, what they appear to be dumping, etc.
28. Photograph or Document Regarding the Complaint
Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit Submit and Print

* indicates a required field