Warrington Borough Council

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Fly-tipping form

Title:

Forename:

Surname:

Address line 1:

Address line 2:

Address line 3:

Postcode:

Telephone:

Email:

State area:

Location of incident (be as precise as you can e.g. 'on the corner of, opposite, street name):

What type of rubbish is it?

Did you see the flytipping happen?

If yes, how many people were there?

Details of vehicle - type / colour / registraion

Was there a business name on the vehicle

Date and time of incident:

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