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Stormwater Illicit Discharge Detection & Elimination Report

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This form has been modified since it was saved. Please review all fields before submitting.

Steps

1. Date/Time/Location Details(current) This section is complete This section is incomplete
2. Who is reporting this event? This section is complete This section is incomplete
3. Event Details This section is complete This section is incomplete

Date/Time/Location Details

Date of Illicit Discharge:
Date of Illicit Discharge:
Date of Illicit Discharge:
Duration:
Address of Discharge:
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Who is reporting this event?

Name:
Phone #:
Is a South Salt Lake City employee making this report on behalf of a citizen?
1. Yes
2. No
If yes, please specify employee's name:
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Event Details

Name of Individual and/or Company responsible for this discharge:
Suspected substances being discharged:
Approximate quantity of spill:
Did the illicit discharge enter a creek, river, or lake?
1. Yes
2. No
3. Unknown
Did the illicit discharge enter the storm drain system?
1. Yes
2. No
3. Unknown
Any known or anticipated health risks for exposed individuals associated with the spill?
Additional information about SSL's Personal Data Request Notice
https://sslc.gov/DocumentCenter/View/2264/Personal-Data-Request-Notice---Citywide

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