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ECMC

ECMC Complaint Submission
By submitting this form, you are requesting an investigation of compliance with ECMC rules. Please provide as much detail related to location and issue as possible. Without enough detail, the ECMC will not be able to process or investigate the issue and, therefore, the ECMC will have no choice but to discard the complaint. If you are unable to complete this form, you may file a written complaint via email instead -- Email ECMC Complaints
 
A red asterisk (*) on this form indicates a required field.
 
  Complaint Information  
 
Date of Complaint *
 
Complaint Type *
 
 
Incident Location (County) *
 
Connection to Incident *
 
 
Will you provide personal information or do you prefer to remain anonymous?
 
  Contact Information  
 
First Name *
Last Name *
Address *
City *
State *
Zip Code *
Email Address *
Phone Number *
  
Alternate Phone
  
 
Preferred method for the ECMC to communicate with you throughout the investigation: *
 
  Complaint Description  
 
Location of Concern: *
Please be specific and provide as much detail as possible. It is important to narrow down the location.
 
Detailed Description of the Issue(s): *
Please be specific and provide as much detail as possible. It is important to narrow down the issue(s).
 
Is this an ongoing issue(s)? *
Do you know who the oil and gas company is? *
 
Well or Facility Name
Please provide if known.
Well or Facility Number
Please provide if known.
 
  Additional Information  
 
Are there supporting documents you wish to upload?