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2. 
3. Residents are asked to submit odor complaints via this form.
   To expedite the tracking of odor reports from residents living or traveling near the Fort Worth South East Landfill, the City of Kennedale would appreciate you taking the time to complete this form, which will be submitted to Republic Services (as the site operator) and the City of Fort Worth (as the site owner). City of Kennedale staff will also receive a copy of your submission. However, this form does *not* submit to the Texas Commission on Environmental Quality (TCEQ).

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   BACKGROUND: Staff from the cities of Kennedale and Fort Worth met with representatives from Republic Services Thursday, February 4, 2016 to discuss increased odor complaints. During the meeting and tour of the landfill, the discussion focused on both current and planned efforts to minimize odors. If you do notice an unpleasant odor, please complete the following form. Your reports help Republic staff adjust their odor patrol route around the landfill and town, which is done multiple times a day This is why being as specific as possible about where and when you noticed the smell is so important.

5. Contact Information
   This is appreciated, but not required (unless you wish to receive a response).

   Sometimes it is helpful to be able to follow up in case questions arise.

7. First Name
8. Last Name
9. Do you wish to be contacted?*

   1. Yes, by phone.
   2. Yes, by email.
   3. No.
11. Address
13. Address (line 2)
15. City
16. State
17. Zip
19. Daytime Phone
    Only necessary if you wish to be contacted. Please leave a number where you can be reached during the hours of M-F 8 a.m. to 5 p.m.
20. Email
    Only necessary if you wish to be contacted.
24. Odor Report
    Please be as specific as possible.
26. When did you notice the odor?
28. Day of Week*
    -- Select One --SundayMondayTuesdayWednesdayThursdayFridaySaturday
29. Month*
    -- Select One --JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember
30. Day*
    -- Select One --12345678910111213141516171819202122232425262728293031
32. Can you smell it right now?*

    1. Yes, currently.
    2. No, previously.
33. Time
34. AM/PM
    -- Select One --AMPM
36. Where did you notice the odor?*
    This could be an actual physical address, the nearest intersection, or a landmark.
37. How Would You Describe The Odor?*
    -- Select One --Sewage, Rotten Fish, or Cadaver OdorGarbage Odor (Like inside of a trash bag or cart.)Musty, Woody, or Earthy (Like digging in dirt, strong wood odor, or walking along a creek or deep in the forest after a rain.)Gas Odor (Like rotten eggs, sweet onions, or sewer gas)Other
38. How Would You Describe The Odor?
    In your own words... What does it smell like?
39. Additional Comments
    Please let us know if you see a trend regarding time or conditions that seem to make the odor stronger or more noticeable.
Leave This Blank:


44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit

* indicates a required field