Adopt-A-Street/Spot Activity Report

After cleanup, please call 856-CITY (2489) to have bags picked up.

Submit this form after each cleanup.

Adopting Person or Group

Adopted Street/Spot

Cleanup Date

Contact Email

Contact Phone Number

Number of persons participating:

Hours & Bags Info

Number of hours collecting litter:

Number of bags used:

Did you recycle any of the trash you collected?

Yes

Is yes, what and approximately how much?

Did you notice any littered or clogged storm drains?

Yes

Is yes, please describe location area (street), etc.

Any comments you would like to share with us?

Today's Date

Your signature here.

First Name

Last Name

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