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Adopt-A-Block Clean Up Tracking
To report graffiti log on to
http://www.accesshayward.com/
or contact Community Preservation at 510.583.4143 for private property or Maintenance Services at 510.881.7745 for public property.
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* Indicates required question
Group:
*
Your answer
Person Reporting
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Your answer
Date of Clean Up?
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Your answer
Items Collected
Please list how many of each item were collected.
Bags
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Your answer
Shopping Carts
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Please also list name of stores
Your answer
Tires
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Your answer
Wooden Planks
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Your answer
Cardboard Boxes
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Your answer
Bed FrameS
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Your answer
Sofas
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Your answer
Mattresses
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Your answer
Chairs
*
Your answer
Dead Animals
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Your answer
Kitchen Appliances
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Your answer
Rags
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Your answer
Concrete
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Your answer
Tables
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Your answer
Ice Chests
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Your answer
TVs
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Your answer
Toys
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Your answer
Newspapers
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Your answer
Christmas Trees
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Your answer
Lamps
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Your answer
Doors
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Your answer
Paint Cans
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Your answer
Other
Please list item description and amount picked up.
Your answer
Additional Comments or Concerns?
Your answer
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