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Complaint Submission Form

For ADEM to address your complaint adequately, you must provide certain information. Please describe your complaint in as much detail as possible. Include information about when you first noticed the problem and how often it occurs. State specifically where it is from, if known. It would be beneficial if you included the name and address of the source. If you do not have an address for the complaint site, driving directions beginning at a major intersection will be necessary. Be sure the driving directions are complete. You are not required to submit your name, address, phone number, or email address.

Who is the complaint about?
Address (including directions to the site if needed):
County:	Autauga Baldwin Barbour Bibb Blount Bullock Butler Calhoun Chambers Cherokee Chilton Choctaw Clarke Clay Cleburne Coffee Colbert Conecuh Coosa Covington Crenshaw Cullman Dale Dallas De Kalb Elmore Escambia Etowah Fayette Franklin Geneva Greene Hale Henry Houston Jackson Jefferson Lamar Lauderdale Lawrence Lee Limestone Lowndes Macon Madison Marengo Marion Marshall Mobile Monroe Montgomery Morgan Perry Pickens Pike Randolph Russell St Clair Shelby Sumter Talladega Tallapoosa Tuscaloosa Walker Washington Wilcox Winston Gulf of Mexico
When did the event occur?
Please describe your complaint, providing as much detail as possible.
I would like to remain anonymous.
I would like to leave my contact information.
Name:
Phone:
Email Address:

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