INSPECTION REQUEST FORM

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What's your zip code?* This field is required.If you don't see your zip code, please select 'Other'.
Please Select
Please Select
Other
20001
20002
20003
20004
20005
20006
20009
20010
20011
20012
20013
20017
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20024
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20201
20208
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We appreciate your interest in receiving an inspection through the Maintaining Stormwater Practices in the Anacostia program. Unfortunately, this grant program currently only extends to residents in the Anacostia Watershed.

Please check out the Stormwater Maintenance Resource Center for access to free resources and information:

https://www.allianceforthebay.org/stormwater-maintenance-resource-center
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Name* This field is required.
First Name
Last Name
4
Preferred Pronouns* This field is required.
she/her/hers
he/him/his
they/them/their
prefer not to say
Other
5
How did you hear about the Anacostia Maintenance program?* This field is required.Select all that apply.
Email
Social media
Word-of mouth
Other
6
Phone Number* This field is required.
###-###-####
7
Email* This field is required.
example@example.com
8
Address* This field is required.Please include full address of site where practices will be inspected.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
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Canada
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China
Christmas Island
Cocos (Keeling) Islands
Colombia
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Cook Islands
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Cote d'Ivoire
Croatia
Cuba
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Cyprus
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Democratic Republic of the Congo
Denmark
Djibouti
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Ethiopia
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Faroe Islands
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French Polynesia
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The Gambia
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Laos
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Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
9
Where is your stormwater practice located?* This field is required.
Montgomery County
Prince George's County
Washington, DC Ward 4
Washington, DC Ward 5
Washington, DC Ward 6
Washington, DC Ward 7
Washington, DC Ward 8
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What type of stormwater practice(s) do you have? (Washington, DC)* This field is required.
Rain garden
BayScape
Rain barrel
Permeable pavement
Trees
Impervious surface removal
11
What type of stormwater practice(s) do you have? (Prince George's County)* This field is required.
Rain garden
Rain barrel
Cistern
Permeable pavement
Urban Tree Canopy
Green roof
Pavement removal
12
What type of stormwater practice(s) do you have? (Montgomery County)* This field is required.
Rain garden/ bioretention
Conservation landscaping/BayScape
Bioswale
Rain barrel/ cistern
Infiltration trench
Permeable pavement
Trees
Green roof
Impervious surface removal
Dry well
13
What is your property tax ID number? (Prince George's County)Don't remember your property tax ID number? Use this link to find your property tax ID number or email the Rain Check Rebate Team at rebate@cbtrust.org: https://sdat.dat.maryland.gov/RealProperty/Pages/default.aspx
14
What is your property tax ID number? (Montgomery County)Don't remember your property tax ID number? Use this link to find your property tax ID number: https://www2.montgomerycountymd.gov/DEPWQPC/SearchResults.aspx
15
What is your preferred method of contact?* This field is required.Select all that apply.
Phone call
Email
Text message
Should be Empty: