Please complete the following frm then click the "submit" button to send this information to the Department of Engineering and Public Works. You may remain anonymous; however, this will prevent the department from contacting you should they have questions or need additional information. You may also e-mail trash@leesburgva.gov or phone 703-771-2790.
Name:
Address:
City, State, Zip:
Phone Number:
eMail Address:
Please enter the address, intersection or other information that would be helpful in identifing the location of the alleged incident:
Please describe the alleged incident in as much detail as possible:
