Standing Water Report

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Please correct the fields below:

Please correct the field(s) marked in red below:

County Administration Building
P.O. Box 3000
Somerville, New Jersey 08876-1262

908.231.7155 Fax 908.704.8042

Only Submit if water has been standing for at least 5 days or more

Enter the date:

Please provide the following contact information:

First Name:

Last Name:

Street Address:

Address (cont.)

City

If your city is not listed, please contact your local health department for assistance.

City If your city is not listed, please contact your local health department for assistance.

Zip/Postal Code

Work Phone

Home Phone

E-mail:

Location of (ie:stream,pool,standing water,tires)

Cross Street and/or Landmark for Identification of Location

Additional Information

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Email Address