Friday, January 27, 2012   9:40 PM
Health and Environment Committee
Portland, Oregon
NWDA Home Page Odor Complaint PortlandAir Home Page
WHEN YOU SMELL IT, REPORT IT !
The single most important action is that citizens complain to DEQ when they smell odors in the neighborhood.
Please report any unusual odors using the following form.
If you have multiple reports, submit individual odor reports for each case.
All complaints are forwarded to DEQ and a copy is retained at NWDA.
You have the additional option of having a copy of your complaint forwarded to the odor source, if possible.
There are 18 questions in this survey.
Text questions allow a maximum of 50 characters unless otherwise noted.
Questions marked with * are required.
* 1. Address where odor was noticed
Please indicate a specific street address if possible; otherwise enter an intersection, description of location, etc.
* 2. Date Odor was Noticed
Pick a date Use calendar  -or-  enter date format: yyyy-mm-dd
* 3. Time Odor was Noticed
Choose one of the following answers:
4. Duration of Odor
Choose one of the following answers:
Less than 15 minutes More than 15 minutes No answer
5. Suspected Odor Source
Please Note - We strongly encourage you to specify a suspected odor source (business, activity, etc.) in order to assist DEQ in processing complaints.
6. Send a copy of complaint to Suspected Odor Source
Choose one of the following answers:
Yes No
If you specified a Suspected Odor Source, would you like a copy of this complaint sent to them, if possible ?
7. Priority
Choose one of the following answers:
High Medium Low No answer
8. Odor Type
Check any that apply:
Metallic
Chemical/Paint
Burning Rubber
Burnt Toast
Sweet/Floral
Acrid
Unburned Fuel
Combusted Diesel
Plastic
Asphalt
Other: Max 20 chars
9. Intensity
Check any that apply:
Annoying
Closed Window
Eye/Throat Irritation
Nausea/Burning Eyes
10. Effects
Check any that apply:
Headache
Difficulty Breathing
Nausea
Sleepiness
Dizziness
Eye Irritation
Throat Irritation
Nose Irritation
Racing Heart
Asthma
Bad Taste in Mouth
11. Additional CommentsMax 250 chars
Your Contact Information
*12. Contact Name
13. Contact Street Address
*14. Contact City
Choose one of the following answers:
Portland Other: Max 20 chars
*15. Contact State
Choose one of the following answers:
*16. Contact Zip Code
Choose one of the following answers:
97210 97209 Other: Max 5 numbers only with no spaces
17. Contact Phone Number
Max 10 numbers only with no spaces
18. Contact Email Address
Max 100 chars
T O P