SB1383 Violation Complaint Form
In complying with California Code Section 18995.3 (Jurisdiction Investigation of Complaints of Alleged Violations). The City of Moreno Valley will make reasonable efforts to protect the confidentiality of complainants.
Date Complaint Received
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Month
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Day
Year
Date
Complainant Information: Would you like to remain Anonymous?
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Please Select
Yes
No
Name
*
First Name
Last Name
Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Alleged Violator Information
When reporting activity that appears to be a violation, please provide information about the location of the activity and the names of any individuals, businesses, or entities engaged in the activity. Please report as much information you have about where the alleged violation(s) occurred and the names and addresses of anyone responsible.
Identity of Alleged Violator (If Known)
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Alleged Violator Type
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Please Select Option Below:
Community/Residential
Solid Waste Hauler
Local Government Agency
State or Federal Government Agency
Public School or University
Business
Alleged Violator Phone Number
Please enter a valid phone number.
Alleged Violator Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Description of the Alleged Violation
Please help us identify what alleged violations were observed. Click all that apply and/or provide details in the box provided.
Date of Alleged Violation
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Month
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Day
Year
Date
Alleged Violation Description (select all that apply)
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Improper Sorting/Disposal or Contamination of Materials
Missing Signage or Labeling on Waste Bins
Missing Blue or Green Waste Bin
No Edible Food Recovery
Lack of Education and Outreach Materials on How to Dispose of Materials.
Other
Photo Attachments
Additional Information
Witness information will only be made available to authorized government employees who are responsible for conducting the investigation related to your complaint. Please put N/A if it does not apply.
Additional Witnesses (Name, Contact Information, Description)
Submit
Should be Empty: