2. To request service from the Department of Public Works, you may either:

   • request service at the Public Works office, located at 440 South Main Street, during normal business hours
   • call the Public Works office at (760) 922-6611
   • complete the fields below which will be sent to Public Works

   This service request form will help us identify a problem in your area that needs service. Should a problem require urgent attention, please call us immediately. For police emergency dial 911.

   Thank you for your assistance.

4. Contact Information
6. First Name*
7. Last Name*
9. Address1*
11. Address2
13. City*
14. State*
15. Zip*
17. Phone Number*
18. Email Address*
20. Please indicate the nature of your problem by checking the appropriate box(es) below:
22. 1. Damaged Curb
    2. Damaged Sidewalk
    3. Discolored Water
    4. Loose/Protruding Manhole Cover
    5. Meter Leaking

    1. Overhanging Tree(s)/Shrub(s)
    2. Pothole
    3. Road Striping
    4. Sewer Leaking/Blockage

    1. Stormdrain Blockage
    2. Traffic Signal(s)
    3. Traffic/Road Sign(s)
    4. Water Leak
24. Brief Description (or other problem not listed)
26. Location of Problem
28. Has this previously been reported?
    -- Select One --NoYes
29. If yes, when?
    If yes, when?
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit Submit and Print

* indicates a required field