Road Watch Group
Today's Date
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Contact Person
Street Address
Email
City
State/Region Post Code
Phone
DETAILS FOR THE DAY
Site location
Council rubbish removal?
Yes
No
Interesting or unusual items found?
Estimated amount of rubbish removed (bags filled/kg)
SUMMARY OF THE DAY
Please provide details of your Clean-up
SUMMARY OF YOUR OBSERVATIONS
Please outline the most common materials found
Has there been any improvement in the amount of littersince your last clean-up?
Was there any indication of the major source of litter collected?
Other comments
Do you require any assistance or information?
If so please specify
Date of your next Clean-up
Do you have any suggestions regarding the Road Watch program?
Please fill in this form and keep us up to date
