Illegal Dumping - Application for Site Clean-Up
Street Address
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City
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Zip
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Or Intersection
Street 1
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Street 2
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Your Information
Name
*
Street Address
*
City
*
Zip
*
Contact Phone
*
Email
*
Keep your information confidential?
No
Yes
*
Additional Information:Include reason for site nomination and (if known) nature of material, estimated weight, any physical barriers, property owner information, etc.
*
Please don't change the next two fields.
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