Free DT2214 ADOPT-A-HIGHWAY CLEAN-UP REPORT - Wisconsin


File Size: 51.4 kB
Pages: 2
Date: March 31, 2009
File Format: PDF
State: Wisconsin
Category: Government
Author: WisDOT
Word Count: 449 Words, 3,013 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.dot.wisconsin.gov/forms/docs/dt2214.pdf

Download DT2214 ADOPT-A-HIGHWAY CLEAN-UP REPORT ( 51.4 kB)


Preview DT2214 ADOPT-A-HIGHWAY CLEAN-UP REPORT
ADOPT-A-HIGHWAY CLEAN-UP REPORT
DT2214 4/2009

Wisconsin Department of Transportation

Clear Form

Please complete this report and submit it to the appropriate Highway Region Office. We prefer that you send your completed report via e-mail. You may also send it via the U.S Postal Service. See page 2 of this application for the appropriate e-mail or postal service address.
Cleanup Date Group Name Location Number of Participants Total Number of Bags Used County Number of Recyclable Bags Used Permit Number / Group Number

For additional bags and vests, contact your county garage. In the space provided below please take the time to provide recommendations or suggestions for improving Wisconsin's Adopt-A-Highway program. We'd like to hear from you.

Thank you for keeping Wisconsin's roadsides beautiful.
E-mail Form
Save Form

Print Form

Adopt-A-Highway contact information

For additional Adopt-A-Highway program information, please contact the Adopt-A-Highway Coordinator listed for the same county in which your highway segment is located. Southwest Region Madison & La Crosse (Counties: Columbia, Crawford, Dane, Dodge, Grant, Green, Iowa, Jefferson, Juneau, Lafayette, La Crosse, Monroe, Richland, Rock, Sauk and Vernon) Coordinator: Donna Sanford 2101 Wright Street Madison, WI 53704 Phone: (608) 246-3871 Fax: (608) 246-5383 E-mail: donna.sanford@dot.wi.gov

Southeast Region - Waukesha (Counties: Kenosha, Milwaukee, Ozaukee, Racine, Walworth, Washington and Waukesha) Coordinator: Tina Hanson 141 NW Barstow St. Waukesha, WI 53187 Phone: (262) 548-5903 Fax: (262) 548-5662 E-mail: tina.hanson@dot.wi.gov

Northeast Region Green Bay (Counties: Brown, Calumet, Door, Fond du Lac, Kewaunee, Manitowoc, Marinette, Oconto, Outagamie, Sheboygan and Winnebago) Coordinator: Roy Tilleman 944 Vanderperren Way Green Bay, WI 54324 Phone: (920) 492-4125 Fax: (920) 492-5711 E-mail: roy.tilleman@dot.wi.gov

North Central Region - Rhinelander (Counties: Adams, Florence, Forest, Green Lake, Iron, Langlade, Lincoln, Marathon, Marquette, Menominee, Oneida, Portage, Price, Shawano, Vilas, Waupaca, Waushara and Wood) Coordinator: Jane Nelson 510 North Hansen Lake Road Rhinelander, WI 54501 Phone: (715) 365-5758 Fax: (715) 365-5780 E-mail: jane.nelson@dot.wi.gov

Northwest Region - Eau Claire (Counties: Buffalo, Chippewa, Clark, Dunn, Eau Claire, Jackson, Pepin, Pierce, St. Croix and Trempealeau) Coordinator: Joan Frey-Pospishil 718 W. Clairemont Avenue Eau Claire, WI 54701 Phone: (715) 836-2831 Fax: (715) 836-2807 E-mail: joan.freypospishil@dot.wi.gov

Northwest Region - Superior (Counties: Ashland, Barron, Bayfield, Burnett, Douglas, Polk, Rusk, Sawyer, Taylor, Washburn) Coordinator: Joseph Whirry 1701 N. 4th St. Superior, WI 54880 Statewide Bureau - Madison James Merriman P.O. Box 7986 Phone: (608) 266-3943 4802 Sheboygan Avenue, Rm 501 Fax: (608) 267-7856 Madison, WI 53707-7986 E-mail: james.merriman@dot.wi.gov Phone: (715) 392-7930 Fax: (715) 392-0879 E-mail: joseph.whirry@dot.wi.gov