NAME OF COORDINATOR: EMAIL:

ORGANIZATION/ COMPANY/SCHOOL: MOBILE NO.:

CLEANUP SITE DESCRIPTION

Type of Environment (choose one):
Saltwater (Ocean/Bay/Estuary)
Freshwater (River/Stream/Lake)
Inland (No Water Body Present)
(Canals/Estero)
Mode of Collection (choose one):
Land (beach, shoreline or inland)
Underwater
Watercraft (powerboat, sailboat, banca,
etc.)

CLEANUP SITE LOCATION

Cleanup Site Name Coordinates
(beach, river, park, (Lat &
etc.): Long):

Province: City/Municipality: Barangay:

CLEANUP SUMMARY
CHILDREN
Number of TOTA (12 yrs. &
Volunteers: L: below): Date:
Estimated Total
Weight of Trash Estimated Total
Collected: (in kilos) No. of Trash Bags Filled:
Estimated Distance
(choos Othe
Cleaned: (in 1/4 1/2 3/4 1 2 3 4 5
e) r:
kilometers)

Most unique or weird item/s collected (indicate no. of

each item)
PLEASE SUBMIT THIS FORM IMMEDIATELY TO
THE ICC NATIONAL COORDINATOR BY EMAIL OR
THROUGH THE FOLLOWING:
EMAIL iccphilippines@gmail.com
: https://sites.google.com/site/iccphilippi
ONLIN nes
E: GERONIMO REYES
ICC NATIONAL COORDINATOR
#3A Omega Avenue, West Fairview
Subdivision
Brgy. West Fairview
1121 Quezon City PHILIPPINES
 MOST LIKELY TO FIND ITEMS MOST LIKELY TO FIND ITEMS

Cigarette Butts Beverage Bottles (Plastic)

Food Wrappers (candy, chips, etc.) Beverage Bottles (Glass)

Take Out/Away Containers (Plastic) Beverage Cans

Take Out/Away Containers (Foam) Grocery Bags (Plastic)

Bottle Caps (Plastic) Other Plastic Bags

Bottle Caps (Metal) Paper Bags

Lids (Plastic) Cups & Plates (Paper)

Straws/Stirrers Cups & Plates (Plastic)

Forks, Knives, Spoons Cups & Plates (Foam)

FISHING GEAR: PACKAGING MATERIALS:

Fishing Buoys, Pots & Traps 6 - Pack Holders

Fishing Net & Pieces Other Plastic/Foam Packaging

Other Plastic Bottles (oil, bleach, shampoo,
Rope (1 yard/meter=1 piece) soy, etc.)

Fishing Line (1 yard/meter=1 piece) Strapping Bands

OTHER TRASH: Tobacco/Cigarette Packaging/Wrappers

Appliances (indicate If television, refs,
washing machine, etc.); (whole not
pieces) PERSONAL HYGIENE:

Balloons Condoms

Cigarette/cigar plastic tips Diapers

Cigarette Lighters Syringes

Construction Materials Sanitary Napkins, Tampons & Applicators

TINY TRASH LESS THAN 2.5 cm (smaller
Fireworks than 25 centavos)

Tires (whole not pieces) Foam Pieces

Shoes/Slippers Glass Pieces
Toys Plastic pieces
Cloth, clothing

Dead / Injured Wildlife & Status (Dead Entangled (Y/ Cause of Entanglement (line, net,
Total Injured) N) plastics)