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2. THIS FORM IS TO REPORT A FIRE HAZARD OR FIRE SAFETY CONCERN IN THE CITY OF WATSONVILLE, CA.

   Use this form if the fire hazard or concern does not require immediate fire department response. 

   If your concern is an immediate threat to life, DIAL 911 IMMEDIATELY.

4. Location/Address of Fire Hazard or Fire Safety Concern*

   Include business name or building name, etc.

5. City*
   -- Select One --Freedom (City limits)Watsonville (City limits)

   Only addresses within Watsonville city limits.

6. Fire Hazard or Concern Type*
   -- Select One --Alarm SystemBlocked ExitsBurning TrashFire HazardLife SafetyOvercrowdedUnsafe ConditionsOther
8. Details*
   Provide a detailed description of the hazard/concern and where on the property/address it is located at.
10. On-Site Contact Information

    Please provide as much information as you can. This will help Fire Department personnel make contact with the appropriate person.

12. On-Site Contact Name
    Name of the tenant/property/business owner if available
13. Title of On-Site Contact
    (tenant, manager, property owner, etc.)
15. Address
    (and/or unit number)
16. Phone Number
18. Reporting Party Contact Information

    1. I would like to remain anonymous. I understand I may be contacted if additional information is needed.
20. Name*
21. Email Address
23. Address
25. City
26. Zip Code
27. Phone Number*
Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

* indicates a required field