CTAP: Consultation Request Form

Please complete to the best of your ability so that we can serve you promptly. Completed CTAP Request Forms are submitted electronically. Please select the "Submit" button below. Due to the nature of Internet transmissions, it is possible that unknown third parties could observe the transmission of information included when submitting this form. Therefore, such information cannot be considered confidential. If you prefer to speak with someone confidentially, please call (800) 988-7901 (in-state) or (317) 232-8172.

Note: This is not a complaint form. Please visit IDEM's Complaints Website if you would like to file a complaint.

Questions marked with a * are required.

 
*1. Company Name:
 
*2. Company Mailing Address (Including City and State):
 
3. Site Address (If Different From Above):
 
*4. Contact Name:
 
5. Title:
 
*6. Contact Phone:
 
7. Company Web site (if available):
 
8. Contact E-mail:
 
9. If you are requesting an on-site consultation, please describe what issues you would like CTAP staff to address during the visit:
 
10. Please indicate what type of business you have and briefly describe your operations.:
 
Consultation services are available to business owners at no cost. Consultation services are confidential, unless a clear and immediate danger to the public health or environment exists. CTAP offers a Quality Assurance Guarantee that assures customers that IDEM will not issue a Notice of Violation assessing a gravity-based penalty against a regulated entity that has sought out, received, and relied upon CTAPís written compliance assistance prior to the alleged violation.