Link to Kitsap County's Mission Statement
Public Works - Solid Waste Division
614 Division Street, Port Orchard, WA  MS-27
Phone: (360)337-5777 * Fax: (360)337-4867
 

    

 

 

 

 

 

 

 

 

1-800-424-5555
CALL BEFORE YOU DIG

 

 

 

 

Adopt-A-Road Program
Volunteer Activity Report

Please report as often as noted in your Adopt-A-Road Agreement.
This information is essential for tracking the success of the program.
Thank you!

Name: 
Phone:
Email Address:
Agreement Number:
Road Location (1)
Date
Start Time         End Time 
Road Location (2)
Date
Start Time         End Time 
Road Location (3)
Date
Start Time          End Time 
Road Location (4)
Date
Start Time          End Time 

How many volunteers participated?         

How many bags of trash were collected? 

How many road miles* were cleaned?     
  * 1 mile = one side of road, both sides = 2 miles

Describe any unusual incidents or injuries during the cleanup:
  

Describe any garbage on private property that should be cleaned up:

 

 

Staff Contact:  Adopt-A-Road Coordinator

Kitsap County Public Works
Solid Waste Division
(360) 337-5777 or (800) 825-4940
solidwaste@co.kitsap.wa.us

 Updated:  June 06, 2008

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