Adopt-A-Highway Summary Report
Answers marked with a * are required.
1. Which cleanup event are you reporting? *


2. Please supply your information *
Group Name
Date Worked
Contact Person
Street Address
3. We need your location and participant information *
Zip Code
# of Participants
Hours Each Person Worked
4. What is your average age group?
5. If you know this information great!
Beginning Post Mile
Ending Post Mile
6. This information is critical! *
Trash Collected (Bags)
Recyclables Collected (Bags)
Vegetation Controlled (Acreage)
Number of New Tree Plantings
Grafitti Removed (Sq Ft)
7. Have you ever kept recyclables found? We encourage recycling! *
8. If you keep recyclables, on average how many bags do you keep during monthly cleanup events?
9. Did you keep any bags of recyclables during this event? *
How many bags of recyclables did you keep during this event?
10. Did you provide advance notice of your plans to work to your Caltrans representative? *
11. It's interesting to read about items you collect, please also provide feedback for improvement!
Most unusual items collected
Suggestions or comments

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