Submit Cleanup Report

  • Submit Cleanup Report

  • We appreciate your participation in our Adopt-a-Program and your commitment to the City of Greensboro! This form serves to ensure that we have a record of your cleanup efforts and to notify staff of any concerns with your adopted location.

    Anyone who submits a form should be aware that in accordance with the North Carolina Public Records law, found in North Carolina General Statutes Chapter 132, their e-mail address is considered public record.

  • Cleanup Date*
     - -
  • Format: (000) 000-0000.
  • Preferred method of contact*
  • What program are you affiliated with?*
    • Adopt a Stream 
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    • Bag Pick up*
    • Did you find hazardous materials or sharps?*
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    • STREAM ASSESSMENT

    • Water Color (choose all that apply):*
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    • Rows
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    • Did you see algae?*
    • Did the algae look excessive or unnatural?*
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    • Was there an unnatural odor present?*
    • Please select what kind(s) of odor:*
    • Did you see dead fish?*
    • Did the fish kill look excessive (5 or more) or unnatural?*

    • STREAM APPEARANCE

    • Did anything look unnatural or out of the ordinary during your visual inspection of the stream?*
    • Bank Erosion*
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    • Blockages: Were there any debris or debris piles that could cause your stream to flood? For example: blocked culverts, pipes, or bridges. This provides important information so that the city staff can remove debris*
    • Large Items: Were there any large items or piles of heavy items that your group could not remove? For example: textiles, tires, furniture, mattress, car parts, shopping carts. This provides important information so that the city staff can remove debris*
    • Adopt a Park, Street, Trail 
    • Did you leave bags for pickup?*

    • Rating Assessment Area

      • Rate the area 1 through 5 stars: 1 meaning the area needs immediate attention and 5 meaning the area is excellent.
      • Please note if anything looked unnatural or out of the ordinary during your visual inspection.
    • Additional warning/caution signs needed?
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