Location
& Description of Problem
The address
must be entered correctly for the report
to be processed and sent to the correct
district and the Streets Department.
Incorrect, misspelled or incomplete
data will return a negative response
and cannot be processed.
Select
your district from the pull-down list.
If you do not know your district, view
the district map and find the district
that covers your address.
Patrol
District:
select
from list
1st District
2nd District
3rd District
4th District
5th District
6th District
7th District
8th District
9th District
12th District
14th District
15th District
16th District
17th District
18th District
19th District
22nd District
23rd District
24th District
25th District
26th District
35th District
39th District
92nd District
Center City District
Only
enter the numerical address number in
this space.
Street Number:
Select
your street direction here.
If there is no direction, select "Not
Applicable".
Street Direction:
select
from list
Not Applicable
N
S
E
W
Enter
only the street name here.
For example: enter "Roosevelt"
(without the quotes) if you live on
Roosevelt Boulevard. DO NOT enter the
street type.
Street Name:
Select
the street type from the list provided.
If the street type isn't on the list,
please contact
the webmaster so the form can be
updated.
Street Type:
you
must select one
Alley
Avenue
Boulevard
Court
Circle
Drive
Expressway
Highway
Lane
Parkway
Pike
Place
Plaza
Road
Run
Square
Street
Terrace
Trail
Way
Choose
the nature of the report you are making
from the drop-down menu.
Report Nature:
you
must select one
Common
Pothole
Sinkhole
/ Street Cave-In
Missing
Traffic Sign
Defective
Traffic Light
Faded
Street Lines
Oil
Spill on Street
Defective
Street Light
Exposed
Wires on Traffic/Street Light
Unrepaired
Utility Ditch
Snow
Plow/Salting Request
Fallen
Tree/Branches
Please
check the appropriate box If the condition
location meets one these conditions.
Special
Conditions:
Complete
this area if you are reporting a pothole,
sinkhole or collapsed street:
This information
is required by the Department of Streets.
Select
the location of the pothole you are
reporting. You will have a chance to
elaborate elsewhere on the form.
Where
is the hole:
Select
from List
On
Sidewalk
Roadway-Traffic
Lane
Roadway-Parking
Lane
Other (Identify
Below)
If
the activity was not on the list,
please tell us what it is in this field.
If
"Other," Identify:
Tell
us the approximate width, height and
depth of the hole.
Hole
Size:
Is
there are barricade over this hole?
Is Hole
Barricaded?
Yes
No
Tell
us if you see water or hear it running
somewhere in the hole. This will give
us an indication of whether a water
main failure or drainage problem has
contributed to its formation.
Water
in Pothole?
Hear Water Running
Standing Water Only
No Water in Hole
Tell
us more about this condition. Describe
it in detail, how long its been there,
what created it, what actions have been
taken to fix it, and anything else you
think would help us take corrective
action.
Describe
the Hole:
Your
Information
This area
is completely optional. You do not have
to provide this information to us. It
will only be used if we need to contact
you for additional information and will
be kept strictly confidential.
Your Name:
Your Street Address:
(no P.O. Boxes)
Apartment Number:
City & State:
Zip Code:
Daytime Phone:
May we call you?
Yes
No
Your E-mail :
Additional
Comments:
When
you click "Submit" the information
you provided will automatically be routed
to the police district or unit you selected
on the form. In addition, a copy will
be forwarded to the Customer Service
Unit of the Philadelphia Streets Department.
Important Disclaimer:
Communications made through this electronic
mail and message system shall in no
way be deemed to constitute legal notice
to the City of Philadelphia, the Philadelphia
Police Department or any of its agencies,
officers, employees, agents, or representatives,
with respect to any existing or potential
claim or cause of action against the
City or any of its agencies, officers,
employees, agents, or representatives,
where notice to the city is required
by any federal, state or local laws,
rules or regulations.