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GOVERNMENT OF THE DISTRICT OF COLUMBIA (City of South Fulton)

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GOVERNMENT OF THE CITY OF SOUTH FULTON
ODIE DONALD II
CITY MANAGER
A
NTONIO
M.
V
ALENZUELA
PUBLIC WORKS DIRECTOR
Adopt-a-Road Program
What is “Adopt-a-Road”?
Adopt-a-Road is a litter prevention and beautification program sponsored by the Public Works
Department to attract public involvement in beautifying and picking up litter along the City of
South Fulton roadways. The objective is to keep City of South Fulton cleaner and greener by
allowing the community to assume responsibility for sections of the public right-of-way.
Who Can Adopt?
Any civic focused organization, such as Garden Clubs, Boy Scouts, Girl Scouts, Church groups,
High School Student Councils, Business Associations, and Corporations can adopt a stretch of
roadway in the City of South Fulton.
What Are the Responsibilities of an Adopting Organization?
By adopting a stretch of roadway, an organization commits to keep City of South Fulton cleaner
and greener. More specifically, the organization will:
• Coordinate volunteers within the organization to improve the appearance of their adopted
roadway. An organization can also participate by sponsoring other volunteer groups, or
directly funding litter cleanup efforts.
• Designate an “Adopt-A-Road Organization Leader and Co-leader, who are eighteen years
of age or older and provide Public Works Department with the person’s names, address
and phone numbers.
• The Organization Leader(s) shall provide each participant with a Release of Liability and,
if necessary, Parental Consent forms in the form approved by the City. The Organization
Leader(s) shall require that every participant in the clean-up of the adopted area complete
and sign these appropriate forms. Parents or guardians of participants 17 years of age or
younger must sign the Parental Consent and Release of Liability form in the form
approved by the City. The Organization Leader(s) will ensure that no one works without
the appropriately signed forms.
• The Organization Leader(s) are required to complete a mandatory Safety Training
Session provided by the Public Works Department. Staff will contact the Group Leader to
schedule the training date. The session would be approximately 30-to 45 minutes.
GOVERNMENT OF THE CITY OF SOUTH FULTON
ODIE DONALD II
CITY MANAGER
A
NTONIO
M.
V
ALENZUELA
PUBLIC WORKS DIRECTOR
• The Organization Leader(s) will require anyone present in the adopted area to wear the
appropriate safety vest and attire and to work only after the warning signs are properly in
place.
• Following each Adopt-A-Road litter cleanup; please report the following information to
the Public Works Department. (1) Organization Name (2) Date of Clean up (3) Section
of Roadway (4) Number of Bags Filled (5) Number of Participants (6) Hours Spent
Cleaning (7) Additional Comments or Observations.
• The Organization assumes all responsibility and liability for, and shall defend and hold
the City of South Fulton, Public Works Department, its officers and employees harmless
from any actions at law or claims of any character brought for injuries, including death,
or damages sustained by any person or property arising from any act or omission of the
Organization or anyone associated with it in performing or failing to perform pursuant to
this Agreement.
• The Organization shall require all participants to be at least 12 years of age and shall have
those participants 17 years of age or younger supervised by one or more adults.
What Are the Responsibilities of Public Works Department?
By supporting the Adopt-a-Road program, the Public Works Department will:
• Furnish and erect two road signs indicating the section of roadway under adoption and
the responsible organization
• Furnish supplies and equipment to aid with general cleanup
• Provide staff assistance in carrying out the program
• Coordinate media coverage to inform the public of the program
GOVERNMENT OF THE CITY OF SOUTH FULTON
ODIE DONALD II
CITY MANAGER
A
NTONIO
M.
V
ALENZUELA
PUBLIC WORKS DIRECTOR
How Does an Organization Adopt?
Any interested group should contact the Public Works Department Adopt-A-Road Program
Staff.
City of South Fulton
Public Works Department
5440 Fulton Industrial Boulevard
Atlanta, GA 30336
Antonio Valenzuela, Public Works Director
404-640-1528
GOVERNMENT OF THE CITY OF SOUTH FULTON
ODIE DONALD II
CITY MANAGER
A
NTONIO
M.
V
ALENZUELA
PUBLIC WORKS DIRECTOR
Safety Tips and Reminders
1. Before you start: Conduct a safety training session before the cleanup.
2. Get ready:
Meet at a convenient place.
Consent to work; have copy of signed Releases.
Remind your group members of the safety tips.
Put on your safety vests and attire.
Check to make sure members have gloves, bright colors, long sleeves shirt, long pants,
high top shoes/boots and socks.
Double-check your supplies (trash bags and signs)
3. Let’s go!
Carpool to your site.
Install your “Traffic Control” Signs.
Park your vehicle off the road where it will not affect the flow of traffic.
4. Clean-up instructions:
Work in groups of 3 to 4 people. Watch out for each other.
Clean four (4) feet from the edge of the pavement.
Fill the garbage bag two-thirds (2/3) fill of litter.
Tie the bag and place it four (4) feet from the edge of the road.
Appoint a “recycler” to pick up the bag of aluminum cans.
5. First Aid Kit
Keep a First Aid Kit near by
6. Special cautions
Watch for stinging insects, fire ants and snakes.
Beware of broken glass, hidden holes, and poison ivy.
Don’t touch suspicious items (e.g. needles).
7. Stop! Stop! Stop!
During bad weather Peak traffic hours
After dark in construction areas
Bridges or overpasses High grass or steep slopes
8. IN CASE OF EMERGENCY CALL 911
GOVERNMENT OF THE CITY OF SOUTH FULTON
ODIE DONALD II
CITY MANAGER
A
NTONIO
M.
V
ALENZUELA
PUBLIC WORKS DIRECTOR
Release of Liability
In consideration of being allowed to participate in the Adopt-A-Road program by the City of
South Fulton, I acknowledge that working in the vicinity of the streets and roads can be a
hazardous activity and I assume all the risks associated with this work. I waive all claims for
damages against the City of South Fulton, and against its officers and employees for injury to my
person or property, including death and destruction, that may arise from this activity. I release
the City of South Fulton and its officers and employees and agree to hold them harmless from
any such liability.
This agreement shall remain in force until I revoke it in writing
__________________________________
Name of Organization
__________________________________
Signature of Participant
__________________________________
Print Name
__________________________________
Date
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GOVERNMENT OF THE CITY OF SOUTH FULTON
ODIE DONALD II
CITY MANAGER
A
NTONIO
M.
V
ALENZUELA
PUBLIC WORKS DIRECTOR
Parental Consent Release of Liability
In consideration of my child, _________________________________, being allowed to
participate in the Adopt-A-Road program by the City of South Fulton, I acknowledge that
working in the vicinity of the streets and roads can be a hazardous activity. Nevertheless, we
grant permission for our child to participate in this activity and assume the risks associated with
this work. We waive all claims for damages against the City of South Fulton, and against its
officers and employees for injury to our child’s person or property, including death and
destruction, that may arise from this activity. We release the City of South Fulton and its
officers and employees and agree to hold them harmless from any such liability.
This agreement shall remain in force until I revoke it in writing
__________________________________
Name of Organization
__________________________________
Signature of Parent/Guardian
__________________________________
Print Name of Parent/Guardian
__________________________________
Date
GOVERNMENT OF THE CITY OF SOUTH FULTON
ODIE DONALD II
CITY MANAGER
A
NTONIO
M.
V
ALENZUELA
PUBLIC WORKS DIRECTOR
Rules and Regulations
General
1. All adopting organizations must sign an Adopt-a-Road agreement and participate in
safety training/orientation.
2. Public Works Department will have final approval of all routes and clean up scheduling.
3. Organizations must perform litter clean up four times per year. Additional cleanup is
encouraged on an as-needed basis, but not required.
4. Adopted road segments will measure a minimum of 2 miles in length, (excluding
bridges).
5. Organizations must make a minimum 2-year commitment to the program.
6. Organizations must schedule clean ups a minimum of 10 working days in advance.
Public Works Department Responsibilities:
1. Signage
a. Public Works Department will erect two sets of signs, one on either end of the
adopted road section.
b. The sign set will consist of a 24 x 30” City of South Fulton Adopt-a-Road
program sign, and a 9” by 24” daughter sign with the organization’s name.
c. Signs will be erected within 3 months of initial adoption, as indicated by a signed
and approved Adopt-a-Road agreement.
d. Signs may be moved or removed at any time at the discretion of Public Works
2. Litter Pick Up
a. Public Works Department will send maintenance crews to pick up filled trash
bags on the first working day after a cleanup.
3. Contact Person
a. Public Works Department will designate one or more staff contacts for the
scheduling and coordination of the program.
GOVERNMENT OF THE CITY OF SOUTH FULTON
ODIE DONALD II
CITY MANAGER
A
NTONIO
M.
V
ALENZUELA
PUBLIC WORKS DIRECTOR
Adopting Organization:
1. Civic and Non-Profit Organizations, Others, etc.
a. Participants must be at least 12 years of age.
b. If under age of majority, participants must have written consent.
2. Commercial Organizations
a. Cannot display address, phone number, or any other contact information during
clean ups
b. Cannot display any product or service reference during clean ups
c. Organization daughter sign may only be used with Adopt-a-Road main
3. All organizations must be approved by Public Works Department.
4. All organizations must complete safety training as required.
5. Organizations must complete a status report and return to Public Works Department after
each clean up.
6. Any organization failing to perform satisfactorily will be removed from the program.
Safety
1. Public Works Department will advise and assist with safety as necessary.
2. Any organization failing to follow safety guidelines will be immediately removed from
the program.
3. Safety Guidelines:
a. Carpools are encouraged to limit the number of vehicles
b. Park vehicles clear of roadway
c. Keep work groups to a manageable size
d. Closely supervise youth groups
e. Do not remove any hazardous material—advise Public Works Department in
status report
f. No clean up on bridges, tunnels, or overpasses
g. Stay clear of construction areas
h. No clean up during inclement weather, at night, or during peak weekday traffic
hours
i. Be aware of natural hazards such as poisonous plants, insects, snakes, etc.
j. Consider any participant’s known medical state before cleaning up, i.e. allergies,
asthma, lack of mobility, etc.
k. Participants may not possess or distribute alcohol while involved in a clean up
l. No illegal substances will be tolerated
m. Make all participants aware that they are working in a potentially dangerous
environment and act accordingly
1
City of South Fulton Adopt-A-Road Program
Responsibilities
1. Does anything else, other than the Release, need to be signed for adult volunteers?
• A Release of Liability form shall be executed for adult volunteers
2. Does Public Works keep the originally signed Releases?
• Yes
3. Would a requestor be entitled to copies of the Releases?
• Yes
4. Are trainings mandatory and how many will be provided?
• There is only one mandatory training provided for all volunteers
5. Is there a limited number of volunteers that should be working at one time?
• No
6. How should “reports” be submitted to Public Works? Is there an existing form?
• A report form is inserted in the program. All status reports should be submitted
electronically to publicworks@cityofsouthfultonga.gov
City of South Fulton
Adopt-A-Road FAQ
2
City of South Fulton Adopt-A-Road Program
Responsibilities to Public Works
1. Will Public Works be on-site for each clean-up? If not, who is responsible for putting out safety
signs?
• Public Works will not be on-site for clean ups. Safety Signs during clean ups are not
provided
2. What is meant exactly by “furnish supplies and equipment?
• Public Works will provide gloves, (loan) safety vests, trash bags, and (loan) trash
pickers
Rules and Regulations
1. What is stated in the “Adopt-A-Road Agreement and can a copy be provided?
• Yes
2. Under what conditions would our signs be moved or removed?
• Upon breaching of contract. “Cleaning 4 times a year” Also at the discretion, at any
time, upon written notice to the undersigned require the termination.
GOVERNMENT OF THE CITY OF SOUTH FULTON
ODIE DONALD II
CITY MANAGER
A
NTONIO
M.
V
ALENZUELA
PUBLIC WORKS DIRECTOR
Indemnification and Maintenance
State of Georgia
City of South Fulton
Whereas, the City of South Fulton, Public Works Department and
____________________________________ recognize the need and desirability of litter-free
roadways; and
Whereas, the “Adopt-a-Road” program has been established for civic organizations, non-profit
organizations, and interested parties to contribute toward the effort of maintaining litter-free
roadways and right-of-way’s by participating in litter pick-ups; and
Whereas, ____________________________________ is aware of the potentially hazardous
work which is to be performed; and
Whereas, ____________________________________ agrees to abide by the Adopt-a-Road
Rules and Regulations attached; and
__________________________________________agrees to cooperate in the development and
implementation of the Adopt-a-Road program, and agrees to indemnify the City of South Fulton
and hold the City of South Fulton and Officers harmless for any and all damage that the City of
South Fulton may suffer.
This agreement shall commence on the date of execution hereof and shall continue to full force
with renewals on a biannual basis.
The Director of the Public Works Department may, in his or her discretion, at any time, upon
written notice to the undersigned require the termination of activities on the City of South Fulton
right-of-way’s.
Therefore, the Public Works Department recognizes
_____________________________________________________________________________
_____________________________________________________________________________
as the adopting organization for roadway within the City of South Fulton.
GOVERNMENT OF THE CITY OF SOUTH FULTON
ODIE DONALD II
CITY MANAGER
A
NTONIO
M.
V
ALENZUELA
PUBLIC WORKS DIRECTOR
Furthermore, ____________________________________ accepts the responsibility of picking
up litter on this section of the City of South Fulton Road, and promoting a litter-free environment
in the community as needed with the minimum of four (4) clean ups per year for a period of no
less than two (2) years from the execution of this agreement.
Road: ______________________________________________________
From: ______________________________________________________
To: ______________________________________________________
Road: ______________________________________________________
From: ______________________________________________________
To: ______________________________________________________
Road: ______________________________________________________
From: ______________________________________________________
To: _______________________________________________________
Name of Organization _________________________________________________________
Authorized Signature ________________________________________ Date______________
Printed Name_________________________________________________________________
Title ________________________________________________________________________
Contact Information ___________________________________________________________
____________________________________________________________________________
Public Works Department Authorized Signature:__________________________Date_________
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Adopt-A-Road Cleanup Report Form
Contact Information
Name:
Organization:
Address: City/State/Zip
Phone Number: E-Mail:
Cleanup Report:
Date/Time of Event:
Name/Location of Area Cleaned:
Total Number of Volunteers: Total Number of Volunteers under 18:
Total Number of Cleanup Hours: Number of Recycling Bags Collected:
Number of Bags Collected: Route # Cleaned:
Comments (please include other items collected):
Date Received
After your event please email this report to the Public Works Department.
email to:
publicworks@cityofsouthfultonga.gov
GOVERNMENT OF THE CITY OF SOUTH FULTON
ODIE DONALD II
CITY MANAGER
A
NTONIO
M.
V
ALENZUELA
PUBLIC WORKS DIRECTOR
5440 Fulton Industrial Blvd., SW • South Fulton, GA 30336 • Office: 470.809.7700
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Completed 22 January 2021

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