Accessibility concern form :: East Bay Municipal Utility District

To file an anonymous notice of concern, please leave the Name and Contact Information section blank.

You will not receive follow up on anonymous complaints.

Would you like to file an anonymous complaint?

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First Name

Last Name

Phone

Alternative Phone

Street Address

City

State

Zip

Person(s) experiencing the concern (if different than applicant)

Which best describes the concern? *

Date of incident *

Time of incident *

Please describe the incident of concern and the names of those involved, and other specific relevant information. *

Is there a change in policy or procedure that you believe would be helpful in resolving this problem?