Oregon Department of Environmental Quality

Testimony Form

(Please print clearly)

Date: _____________________    

Hearing Topic: Air quality permitting, Heat Smart, and gasoline dispensing facility updates

Name: ___________________    Affiliation: _________________________

E-mail: ___________________________________________________________

Mailing Address: ___________________________________________________

I want to receive updates on this topic via:  e-mail    

             postal mail

Oregon Department of Environmental Quality

Testimony Form

(Please print clearly)

Date: _____________________    

Hearing Topic: Air quality permitting, Heat Smart, and gasoline dispensing facility updates

Name: ___________________    Affiliation: _________________________

E-mail: ___________________________________________________________

Mailing Address: ___________________________________________________

I want to receive updates on this topic via:  e-mail    

             postal mail