Clinton County Solid Waste Management Litter Pick-up form

Clinton County Solid Waste Management District

LITTER CLEAN-UP FORM
Your Name *
Email *
example@example.com
Phone Number *

Area Code ###-####
Organization/Group Name (if applicable)
Contact person title (if applicable)
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Planned clean-ups are often along roadways or focus on public parks or waterways.

Please share the details of your ROADSIDE OR PARK/WATERWAY clean-up below. Staff will then contact you and ensure that you and/or your group is well equipped with litter collection kits (bags, gloves, masks, safety vests, and pick-up tools).
ROADSIDE clean-up: Tell us about your plans
Date of clean-up

Month Day Year
PARK or WATERWAY clean-up: Tell us about your plans
Date of clean-up

Month Day Year
Please provide any additional information, comments, questions, etc.
Thank you for taking pride in our community and keeping Clinton County Beautiful!

Please contact Erin Hartsock with any questions.

Erin Hartsock, Outreach Specialist
Clinton County Solid Waste Mgt. District
Phone (937) 382-6177
Email: Recycle@ClintonCountyOhio.us
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