DT2214 ADOPT-A-HIGHWAY CLEAN-UP REPORT



ADOPT-A-HIGHWAY Wisconsin Department of Transportation

CLEAN-UP REPORT

DT2214 9/2012

Please complete this report and submit it to the appropriate Highway Region Office. We prefer that you send your completed report via email. You may also send it via the U.S Postal Service. For the appropriate contact information please see Adopt-A-Highway contacts, at: .

|Cleanup Date |Permit Number / Group Number |

|      |      |

|Group Contact Name (First, MI, Last) |Group Contact Email Address |

|      |      |

|Group Name |

|      |

|Location |County |

|      |      |

|Number of Participants |Estimate Hours for Clean-up |Number of Bags with Trash |Number of Bags with Recyclable Materials |

|      |      |      |      |

|For additional bags and vests, contact your county garage. |

In the space below please take the time to provide recommendations or suggestions for improving Wisconsin’s

Adopt-A-Highway program. We would like to hear from you.

     

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