Litter Clean-Up Summary Sheet
Location of Litter Clean-Up
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Group/Organization Name
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Group Leader
*
Contact Number
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Area Code
Phone Number
Email
example@example.com
CLEANUP STATISTICS
Date Of Cleanup
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-
Month
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Day
Year
Date
Number of Participants
*
About how long did your cleanup last (in hours).
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Full Bags Collected
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Half Bags Collected
Where are your bags of litter? (i.e. Address/street corner of bags.) Litter bags are picked up by city crews every Tuesdays and Thursdays.
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List any large/bulky items with could not be bagged and there location:
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Bags of litter and/or bulky items need to be picked up:
*
Yes
No
Additional comments, areas of concern, or other feedback
Submit
Should be Empty: