Southwest District Citizen Concern Form Question Title * 1. The Southwest District is experiencing problems with its Citizen Concern Survey and is working to repair the issues. In the meantime, if you have a concern you would like to report, please call the district office at 813-470-5700. Thank you, and we apologize for the inconvenience. This was helpful. This was not helpful. Question Title * 2. What is the address of the area of concern (if unknown, provide cross streets)? Question Title * 3. City Question Title * 4. Please choose one or more categories for your concern: Air Quality Beaches and Coastal areas Biosolids Docks Drinking Water Hazardous Waste Oil/Chemical Spill Landfill, dump or other solid waste sites State Lands Storage tanks Storm water Surface water Wastewater/Sewer Systems Wetlands Other (please specify) Question Title * 5. Description of Concern: Question Title * 6. Name (if you wish to remain anonymous, please call 813-470-5700 to submit a concern): Question Title * 7. Phone Number and/or Email: Question Title * 8. Please include any photos or additional documentation that might help us when investigating your concern. DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only. Choose File Choose File No file chosen Remove File Please include any photos or additional documentation that might help us when investigating your concern. Done