PA CleanWays Cleanup Reporting Form

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PA CleanWays Cleanup Reporting Form

To report information about a completed cleanup, please fill out the following form and click submit.

(You may report ONLY ONE CLEANUP AT A TIME using this form.)

Thank you for reporting your cleanup via the PA CleanWays online reporting system. If you have any questions regarding this form, please contact PA CleanWays at 1-877-772-3673.

Please send your cleanup pictures via e-mail to pictures@pacleanways.org. Name your pictures after the dumpsite name (ex., Main Street 1, Main Street 2, etc.). In your e-mail, please include the dumpsite name, the dumpsite survey number, and the county in which the cleanup occurred.

You will receive a confirmation email that this report was processed.

Cleanup Reporting Form:
lName of Person Submitting This Form: (required)
E-mail of Person Submitting This Form: (required)

Group that Hosted Cleanup:
Cleanup Site Name:
Site Number in Survey:
Date of Cleanup:
Time of Event:	From To
County:
Municipality:
Cleanup Contact Name:
Cleanup Contact Phone #:
Cleanup Contact E-mail:

Please fill out the section below for your cleanup. Only one cleanup may be reported at a time using this form. Please name and forward cleanup pictures to pictures@pacleanways.org.

Section 1 - ILLEGAL DUMP/LITTER CLEANUPS
Estimated amount of trash removed - dump/litter cleanups:
----Estimated tons ----(convert all totals to tons using conversion chart below)
----Scrap metal recycled (tons)
Estimated # of tires removed from dump/litter cleanups
Number of bags of trash collected
Pounds of aluminum cans recycled
Pounds of plastic bottles recycled
Pounds of glass recycled
Tires collected for recycling
Number of batteries collected for recycling
Number of appliances collected for recycling
Pounds of construction and demolition waste
Estimated # of dump/litter cleanup volunteers
Estimated # of dump/litter cleanup volunteer hours (# vols x # hrs/vol)

PA CleanWays Trash Conversions/Estimates
(when accurate totals are not available)

100 tires per ton

10-ton single axle dump truck = 2 tons trash (no dirt)

1 trash bag = 25 lbs

30 yard rolloff = 6-8 tons (pure trash); 15-20 tons (with dirt from equipment cleanups)

Pickup truck (8' bed) = 1/2 ton

Recognizing that some bags will weigh more than others, the above figure for trash bag weight conversion is an estimate only.
Where possible, weigh slips from the disposal facility should be used as the accurate reporting method for roll-off weight.

When you are finished reporting event information, press the "Submit Form" button below to send: