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1. Group & clean up details (Required.)

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2. Date of clean up: (Required.)

Date

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3. How many people participated in the clean up? (Required.)

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4. Names of all participants:

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5. Total clean up time in hours: (for group not per person) (Required.)

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6. Estimated length of roadside cleaned (km): (Required.)

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7. Estimated weight of litter (kg):

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8. Number of litter bags used:

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9. Any interesting items collected:

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10. Common litter items collected: (Required.)

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11. Quantity of banned single-use plastic items found:

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12. Were any hazardous/dangerous items found? (e.g. stolen goods/wallets/weapons/ illegally dumped items). If so, were they reported to the relevant agency (Council/Police/EPA)?

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13. Have there been any changes to litter quantities since the last clean up? (Please note the last known clean date)

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14. Further comments about the clean-up or the Road Watch-Adopt A Road program (i.e. trends, suggestions or equipment requests):

T