Pollution Reporting Form

Thank you for taking the time to report a pollution incident. Puget Soundkeeper will follow up with the appropriate agencies. You can call our hotline during business hours, Monday through Friday, 9am to 5pm: 1-800-42PUGET

This is a non-emergency reporting form.

For an emergency situation, such as an oil, fuel, or hazardous chemical spill, please also call both 1-800-OILS-911 and 1-800-424-8802 immediately. If a safety hazard exists, please call 9-1-1.

Incident Time

Date(Required)

Format: mm/dd/yyyy

Time (optional)

Hours

:

Minutes

AMPM AM/PM

Incident Location

1. Set map pin with address or…

…set pin to your location

Find My Position

2. Click or drag pin to precise location (Required)

Please make sure the pin is as close as possible to the precise location of the pollution.

Hidden

Location Details(Required)

Location Description(Required)

Please provide additional details that would help us locate the pollution, e.g. “northwest corner of gas station parking lot near car wash exit”

Incident Details

A detailed description of this incident helps us take action in response to your report.

Detailed description of the pollution(Required)

Pollutant (if known)

Quantity (if known)

Resources at Risk (optional)

(shoreline, birds, mammals, fish, water quality)

Weather Conditions (optional)

(i.e. sunny, cloudy, raining, windy, snowing, etc.)

Please include any photos or documents supporting your report (optional)

Send us a photo (10Mb limit, .jpg preferred)

Accepted file types: jpg, gif, png, pdf, Max. file size: 256 MB.

Have you reported this incident to anyone else?(Required)

Yes

No

Who did you report it to?

Please provide an incident number, ERTS number, etc. if you received one

Your Contact Details (Optional)

We may use your contact details to follow up with you about the details of your report.

Name

First Last

Email

Phone

Can we include your contact details in a report to a state agency?(Required)

Yes

No

Phone

This field is for validation purposes and should be left unchanged.

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