Hazard Report Form

Hazard Details

Hazard Type:

Describe the hazard:

Maximum 400 characters (0 used)

Approximate size:

Approximate depth:

Approximate distance from kerb:

Location Details

Location:

Map Here

Road name:

Describe where the hazard is (so the authorities can find it):

Maximum 250 characters (0 used)

Please assume that the authority is unable to view the map above, and only has this description to find the hazard. Ideally specify the placename, road name, and nearby house number.

Other location information (tick as appropriate):

Hazard is on a canal towpath

Date hazard encountered:

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