2. 
4. The City of Bristol, VA Solid Waste Facility/ Landfill Feedback Form
   Please provide instructional information regarding the city's landfill and its effects on the neighboring communities. Through constructive feedback the city can better address the issues at hand concerning the city landfill. Thank you for your assistance!
6. Contact Information
8. First Name*
9. Last Name*
11. Address1*
13. Address2
15. City*
16. State*
17. Zip*
19. Phone Number*
20. Email Address*
22. Date and Time of the Odor concern
    Date and Time of the Odor concern

    Date and Time of the Odor concern
24. Description of Complaint
26. Type of Odor:
28. Odor Intensity: (based on a scale of 1 through 5)
    -- Select One --12345
30. Weather conditions when Odor was detected:
32. Weather Conditions at the time odors were detected (based on weather monitoring station or internet resources):
    The following information isn't mandatory but certainly helps the City isolate and react to issues.
34. National Weather Service
    https://www.weather.gov/ilm/observations

    National Weather service info. Enter your zip code at the top left search box labeled "Local Forecast"

36. Wind Direction
    -- Select One --NorthSouthEastWest
37. Wind Speed
39. Rainfall
    -- Select One --No RainLight Rain (less than .25")Medium Rain (.25" - .99")Heavy Rain (over 1")
40. Barometric Pressure
42. Humidity
43. Temperature
45. Location of Problem
47. Have odors been noticed at this location in the past?
    -- Select One --YesNo
49. If so, When?
51. Brief Description of Other Concern or Information.
Leave This Blank:


53. 1. Receive an email copy of this form.
54. Email address

    This field is not part of the form submission.

55. Submit Submit and Print

* indicates a required field