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Region 2

Serving New Jersey, New York, Puerto Rico, US Virgin Islands and Eight Tribal Nations.

Wetlands Violation - Initial Complaint Form

This form is to report violations in New Jersey, New York, Puerto Rico, and the U.S. Virgin Islands ONLY. To report violations in other states, please visit our Environmental Violations web page.

About providing your contact information:
You are not required to provide your contact information in order for EPA to review your tip or complaint. However, if you do not provide contact information, EPA may be unable to contact you for additional information that may be needed to determine whether or not an investigation is warranted. If you do provide contact information, this information may be used to initiate follow-up communications with you and may be shared by EPA with appropriate administrative, law enforcement, and judicial entities engaged in investigating or adjudicating the tip or complaint. Please review the EPA Web Privacy Policy for more information.

 

Date:
 

1. Complainant

Name:
Address:
 
Phone:
Email
 

2. Location of Suspected Violation

Street:
Town:
State/Region:
What is the nearest intersection, street, waterbody or other landmark?
 

3. The Activity

a) Is there a discharge of dredged and/or fill material into wetlands or waters? Yes No
b) Is the activity ongoing? Yes No
c) What is the approximate area of filled wetlands or waters? acres or
square feet
d) Is mechanized landclearing taking place? Yes No
e) If the answer to d) is yes, what is the approximate area of land that has been cleared through mechanized landclearing? acres or
square feet
f) When did the activity begin?
 

4. The Parties Involved

a) Landowner's
Name:
Address:
 
Phone:
b) Contractor's
Name:
Address:
 
Phone:
c) Other
Name:
Address:
 
Phone:
 

5. Other Information

a) Do you know if local, state or other federal authorities are involved? If yes, explain:

b) Do you have maps, photographs and/or names of other individuals who might have additional information?

6. Other Comments

 

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