Problem Alert Form

The On-Line Problem Alert Form is a form that is used by the City staff to document and report problems spotted in the field. Now we are bringing that same program to the public through the Internet! If you live, work or are visiting in Oxnard and spot a physical problem, you may fill out the following form and send it to us on the Internet. We will forward it to the appropriate City person/program for action.


Please enter the date and time that the problem was noticed in the space below.

* = Required Fields

 
Date: (mm/dd/yyyy)       

Time: (hh:mm AM or PM)

Location: Please enter the street address (location) where the problem was noticed in the space below.

Problem Noticed:

Please select the problem noticed from the expandable list.

Details:
Please enter any further details (such as street light/utility pole number) that will help us identify where the problem is located or why it might be occurring.

Send The Form
Please enter your name and e-mail address and then click the "Send the Form" button to send the form to Oxnard City Hall for action.

We appreciate your help in keeping Oxnard in top condition by sending us this On-Line Problem Alert Form!

Please enter your name:

Please enter your email address:
 

Please enter your daytime phone number in the event we need more information: (555-555-5555)  


Last Updated: Nov 23 2007