Title *

 Mr.   Mrs.   Ms.

Full name *

Telephone number *

Example: 08xxxxxxxx

Address of the informant (if any)

Places/spots where trash is found. *

Type of uncollected waste *

-- Select --General Garbage.Recyclable wasteOrganic waste/food waste.Large garbage (furniture/beds).Branches / garden wasteOther

Approximate quantity *

-- Select --Small (1-2 bags).Medium (3-5 bags).Many (more than 5 bags/bunch).1-2 large pieces of garbage.Several bulky waste items

The day the garbage was found. *

Urgency *

-- Select --Very urgent (smell/interference/disease risk).Urgent (collection needed soon)MediumGeneral

Landmarks/Nearby Places

Convenient time to contact

-- Select --08:30-12:0013:00-16:30Contactable at any time