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Pollution Reporting Form

2. Thank you for taking time to report a pollution incident. Porter County will follow up with appropriate action. THIS IS A NON-EMERGENCY REPORTING FORM. For an emergency situation, such as an oil, fuel or hazardous chemical spill please call 911.
4. Name will remain confidential unless required by law to submit.
6. First Name
7. Last Name
9. Telephone Number
10. Data and Time of Incident
    Data and Time of Incident

    Data and Time of Incident
12. Serviceable Areas
    Serviceable Areas

    Please visit this link PRIOR to completing this form to ensure you are within our serviceable area. Once you have found your area, please select your area in the dropbox below.
14. Please Note
    If you are in the Porter County Storm Water service area please continue to fill out this form. If you are not indicated as being in the Porter County Storm Water area please contact the service provider listed in the service area map results.
16. Serviceable Area From Above Link*
    -- Select One --Beverly ShoresBurns HarborChestertonDune AcresHebronKoutsLakes of the Four SeasonsOgden DunesPortageTown of PinesTown of PorterValparaisoDamon Run ConservancyFalling Waters ConservancyLake Eliza Area ConservancyNature Works ConservancyTwin Creeks ConservancyValparaiso Lakes Area ConservancyPorter County Storm Water Management

    Please select the serviceable area found from the above link.
18. Location of Incident*
20. Description of Incident*
22. Contact email:*
    Please provide an email you can be contacted at.
Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field