Landfill Odor Complaint Form

2. Date of Odor Occurrence*

3. Time of Odor Occurrence*

5. Location of Odor Occurrence*

7. Duration of Odor Occurrence*

9. General Weather Conditions at the Time of Occurrence*

   Check all that apply:

   1. cloudy
   2. cold
   3. hot
   4. humid
   5. raining
   6. snowing/sleeting
   7. windy
   8. other
10. If "other," please describe:

12. Type of Odor Detected*

    Check all that apply:

    1. chemical
    2. livestock
    3. manure
    4. trash/decay
    5. septic/sewer
    6. musky/earthy
    7. other
13. If "other," please describe:

15. Strength of Odor*

    On a scale from 1 to 5, with 1 being "detectable" and 5 being "offensive"

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5
19. Contact Information

21. First Name*

22. Last Name*

24. Phone Number*

26. E-mail*

28. Address 1

30. Address 2

32. City

33. State

34. Zip

Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field