2. TO: Citizen Services - Report a Problem Spot to the CLEAN Program

4. 

6. Thank you for helping us keep the Town of Babylon CLEAN! Please use the form below to report any problem spots that require our attention. Your input is invaluable in maintaining the beauty and safety of our community.

8. Location Details

10. Location Name*

    [e.g., Street name, park name, landmark, etc.]

11. Nearest Intersection*

    [please include nearest intersections or cross streets] 

13. Description of the Problem*

    [Please provide a detailed description of the issue, including any specific concerns such as litter, overgrowth etc.] 

15. Contact Information (Optional)

17. While providing contact information is optional, it allows us to follow up with you regarding the reported issue if needed. 

19. First Name
20. Last Name
22. Email:
23. Phone Number:

25. Upload Photos (Optional)

27. If possible, please upload any photos of the problem spot. Visual documentation can greatly assist our clean-up efforts and ensure that the issue is addressed promptly and effectively.

29. Upload Photos:

31. Submit

33. Once you have completed the form, click the submit button below to send us your report. Our team will review the information provided and take appropriate action to address the reported issue.

Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field