This is to report the completion of a Roadside Litter Projectand for use in making an accounting to the VA Department of Environmental Quality
Pictures(s) Attached:
(Please use the upload links below for attaching photos.  You may upload 3 photos)  

 

 

 
SEND AND MAKE CHECK PAYABLE INFORMATION:
 
NOTE: All Roadside Litter Projects must be completed and this form submitted by May 5th, 2017.  Any paperwork (online or paper copy) received after that date will not be processed.
 
The approved check will be mailed to your organization during June 2017.
 
THANK YOU FOR YOUR PARTICIPATION IN THIS PROGRAM

Office Use Only

Amount Paid ____________     Ck number __________

PLEASE CLICK SUBMIT TO ELECTRONICALLY SEND THIS FORM DATA!