Date:
Contact Information:
Contact information is optional, however it may assist staff if additional information is needed.
Name:
Phone:
Email:
Address:
City:
State:
Zip Code:
Maintenance Issue Information:
Location/Street Address:
Nearest Intersection:
Parks and Trails - select all that apply:
Graffiti/vandalism
Play equipment hazard
Debris/Dumping
Irrigation/leak, overwatering
Standing/stagnant water
Damaged pavement
Broken/burned out lighting
Hazardous tree/branch
Shelter/picnic damage
Broken glass
Other
Recreation/Rental Facility Cleanliness, Safety, Usability - select all that apply:
Front desk/lobby
Kitchen/dining area
Concessions
Gymnasium/sport courts
Restrooms/locker rooms
Meeting/class/party rooms
Exercise rooms
Doorways/hallways
Pool/aquatic area
Exterior (landscape, parking)
Other areas
Additional Comments or Questions: