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2. Drain Clean-up Report

   Please, fill out this report each time you take care of the drain you adopted. Thank you!

4. Number of the drain you are reporting about*
5. Date you cleaned the drain*
   Date you cleaned the drain
7. Please, describe the amount of debris you removed from the surface of the drain. Example: 1 x 13 gallon bag of leaves/grass.*
9. Anything else you want us to know about the condition of the drain.
11. Attach any photos you would like to share.
12. Attach any photos you would like to share.

14. Photos can also be sent directly to emeyer@plainsboronj.com.

Leave This Blank:


16. 1. Receive an email copy of this form.
17. Email address

    This field is not part of the form submission.

18. Submit

* indicates a required field