Self-haul and back-haul reporting form

Report SB 1383 Noncompliance

Name

Phone

Yes, you may contact me for further details

Name of Entity

Location of Entity

Date Visited

Description

Please describe the alleged violation, including location(s) and all other relevant facts known to you.

Supporting Documentation

Please upload any relevant photographic or documentary evidence to support the allegations.

Witnesses?

Please add the identify of any witnesses to this violation, if known.