2. Date of Odor Occurrence*
3. Time of Odor Occurrence*
5. Location of Odor Occurrence*
7. Duration of Odor Occurrence*
9. General Weather Conditions at the Time of Occurrence*

   Check all that apply:

   1. cloudy
   2. cold
   3. hot
   4. humid
   5. raining
   6. snowing/sleeting
   7. windy
   8. other
10. If "other," please describe:
12. Type of Odor Detected*

    Check all that apply:

    1. chemical
    2. livestock
    3. manure
    4. trash/decay
    5. septic/sewer
    6. musky/earthy
    7. other
13. If "other," please describe:
15. Strength of Odor*

    On a scale from 1 to 5, with 1 being "detectable" and 5 being "offensive"

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5
19. Contact Information
21. First Name*
22. Last Name*
24. Phone Number*
26. E-mail*
28. Address 1
30. Address 2
32. City
33. State
34. Zip
Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

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