Meth-Affected Properties Reporting Form

Property information

Attention: Only law enforcement or certified consultants can submit this form. If you suspect a property has been used as a meth lab, call the police.

Property street address *

Apt/unit/suite

City *

County *

State *

Zip

Property owner *

Owner type *

Individual

Company

Government entity

Residential property type *

Single family residence, including manufactured home, mobile home, condominium, or townhome.

Rental property including apartment.

Short-term residence, including motel or hotel.

Report information

Discovery date * +

First name of person submitting the form *

Last name of person submitting the form *

Affiliation of person submitting this report *

Law enforcement.

Consultant certified under Section 25-18.5-106, C.R.S.

Please enter your certification number *

Please provide your Law Enforcement agency *

Type of discovery (Select all that apply) *

Manufacturing chemicals, equipment or supplies observed.

Evidence of meth use.

Sample results.

Email address *

Confirm email *

Phone *

Documentation

Please select the documentation type. We will include instructions on how to submit documentation in your confirmation email. *

Law enforcement report.

Sample results.

Photos or other documentation.

For the purposes of this form, the Colorado Department of Public Health and Environment accepts your typed name and date as an electronic signature equivalent to your valid signature on a paper copy of the form. As such, this electronically completed form subjects the signatory to the same responsibilities as a hand-signed form. Per Section 18-8-306, C.R.S., it is a felony to submit false information to a state official.

Applicant's signature *

Submittal date * +