Hazard Report Form

Hazard Type:

Pothole

Raised/sunken manhole or drain

Unevenness due to rut or gully

Debris on road surface

Surface poorly restored after roadworks

Other

Describe the hazard:

Maximum 400 characters (0 used)

Approximate size:

Approximate depth:

Approximate distance from kerb:

Location:

Map Here

Road name:

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

Maximum 250 characters (0 used)

Other location information (tick as appropriate):

Hazard is on a Red Route in London

Hazard is between the stop lines at a railway crossing

Hazard is on a canal towpath

Hazard Details