Please be as exact and specific as possible. If you can't provide an exact address please include information such as the distance from road and whether the concern is visible from the road. Describe landmarks such as nearby streams, buildings and roads to help locate the dumpsite.
Property Owner (if known):
*County (if known):	(Choose Unknown if necessary)
Location/Driving Directions: Please provide the exact address (Street, City, Zip)* and/or Location/Driving Directions.

Description of Problem

Please describe your complaint in detail. Include as much factual information as possible relating to "who, what, where, and when". For example did it involve Air Pollution such as burning of rubbish, smoke, odors; Water Pollution from agricultural or commercial activities; Waste complaints such as dumping, etc. Please include any known dates, times, witnesses, type of materials or substances involved, or previous corrective actions that have been taken.

*Description of Problem (in Detail)

Your Information (Optional)

Note: Giving us your name, address, phone number and/or e-mail address is optional. Please note that your questions, comments or complaints will become a public record subject to release under the Arkansas Freedom of Information Act. Therefore, if you wish to remain anonymous, please do not provide your name, address, phone number, or email address when you send us your comments or complaints. However, if you elect to remain anonymous, we will not be able to provide you with any follow-up information. Your privacy is important to us. Please refer to our Privacy Policy for more information.
Name:
Street Address:
City:
State:
Zip: (xxxxx or xxxxx-xxxx)
Phone: (xxx xxx-xxxx)
Email Address:

Internal use only: