ATLANTA POLICE DEPARTMENT

Situations Needing Corrective Action

This form is to be filled out when reporting a situation that needs action by a city department, other than the police department.

Date of report:

Name of reporting officer:

Location of situation:

Action needed:

Check Appropriate Box(es) for Department and Situation:

TRAFFIC ENGINEERING
WATER
Street Lamp(s)	Fire Hydrant
Street Name Sign	Water Meter
Traffic Sign	Other
Parking Meter #
Other
HIGHWAYS/ STREETS
Sidewalk Repairs
SANITATION
Catch Basin Broken
Vacant Lot Cleaning	Catch Basin Stopped
Right-of-way Obstruction	Street Repairs
(Potholes, Etc.)
Dead Animal
Abandoned Property on	Barricades Needed
Public Property
Utility Disrupted
Dumpsters Overflowing	Other
Other

OTHER DEPARTMENT/ AGENCY
List Appropriate Department/ Agency and Situation:

Reviewed by Zone Supervisor:
Name:	Date:
Forwarded to	On
Department
Date

Note: Any of the above situations that present an immediate hazard to persons or property should

be reported to communications for immediate action.

Form APD 711 Revised 1/22/03

Control #__-__ __ __ __

Zone use only

Control # __- __ __ __ __

AJordan

2003-12-18

Atlanta Police Department