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Smoke-Free Campus Reporting Tool
This form has been modified since it was saved. Please review all fields before submitting.
If you notice a regular pattern of smoking or vaping (someone continuing to smoke in a smoke-free area), please use the anonymous reporting tool.
What day did the violation take place?
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What time did the violation take place?
-- Select One --
Before 8 a.m.
8 to 10 a.m.
10 a.m. to Noon
Noon to 2 p.m.
2 to 4 p.m.
4 to 6 p.m.
Weekends or Outside of Business Hours
Location of Violation
Occupation of Non-Complaint Individual (If Known)
Placer County Employee/Staff
Did you inform the non-compliant individual about the smoke-free campus ordinance, and where the designated smoking areas are located?
Anonymous reports are welcome. Do you wish to be contacted about your report? If so, please include your name and contact information below (not required).
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