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Illicit Discharge Report

Filing an Illicit Discharge Complaint
It is the City’s policy to conduct complaint investigations upon receipt of a written complaint, such as this form. It is important to provide accurate and specific information (name of responsible owner/occupant, exact location, time/date of violation). If you have questions, please contact Code Enforcement Officer Davis at 360-363-8381.
Processing your complaint
After your complaint is filed, appropriate City staff will verify whether the complaint is a code violation. If a violation is confirmed, the responsible individual will be requested to take corrective measures to comply with the City Code(s). If compliance has not been met by a date specified, and efforts are not taken to gain compliance, the matter may be referred to the Office of City Attorney for further action.
Public disclosure
Under Chapter 42.56 RCW, the Public Records Act, a Complaint Form is a public record subject to disclosure. You, as a complainant, may request that your identity not be disclosed to the public. If you request that the City not disclose your identity, the City will attempt to honor your preference, but makes no assurances that your identity will not be made public. Additionally, if the complaint results in a case being filed in court, you will most likely be named as a witness and your identity will therefore be disclosed.
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Name of person making complaint*
Address*
Address
City*
State*
Zip*
Work phone
Home/Cell phone*
Email
Public disclosure
Under Chaper 42.17 R.C.W. the Public Disclosure Law, you as a complainant may indicate preference for disclosure of your name to inquiries from the public. Please indicate by checking the appropriate box whether or not you wish to disclose your identity regarding public inquiries into this complaint. Upon such an inquiry, a decision of disclosure will be made by the City Attorney on a case by case basis. However, if the case is filed in court, your name must be disclosed if you are to be a witness.
Please select one*
1. You may disclose my identity upon public inquiries regarding this complaint
1. You may NOT disclose my identity upon public inquiries regarding this complaint without my permission
Electronic signature*
I CERTIFY (OR DECLARE) UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT (RCW 9A.72.085)
Date*
Date

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