Environmental Enquiries/Complaints Form

Please fill out the form below if you would like to make a environmental enquiry or complaint. Please note, complainant details remain confidential; any anonymous complaints will not be actioned.

If you would like to report water pollution, please submit a report on the Environment Watch website.

Complaint/Enquiry Information

What does your complaint/enquiry relate to?*

Please describe the issue or query:*

Site causing concern (address causing problem):*

When and how frequently does the issue occur (for queries please enter N/A):*

Have you made attempts to resolve this matter?*

YesNo

Personal Information

Your Address

Street Address:*

City:*

State:*

Post Code:*

Country:*

Your Name*

Email*

Privacy statement

The personal information collected on this form will be used by the Town of Bassendean to manage and administer its services and meet legal and governance obligations. Your information may be disclosed to relevant third parties where necessary to provide these services or where required or permitted by law.

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