Print
Press Enter to show all options, press Tab go to next option

Online Surveys & Forms

Adopt-A-Drain Sign Up

Please correct the field(s) marked in red below:

Thank you for participating in the Adopt-A-Drain program.  Please fill-out and submit the form below.  If you have any questions about this program, please call: 650-595-7425.

1
What is the Drain ID# of the drain that you would like to adopt?
(Please use the map to zoom-in, then click on the drain to find the Drain ID#.)
 *
2
What is your name?
 *
3
Please provide your email address so we can reach you.
 *
4
Please provide your home address so we can drop off your Adopt-A-Drain Starter Kit.
 *
5
What are your comments or thoughts about the Adopt-A-Drain program?
  1. To receive a copy of your submission, please fill out your email address below and submit.