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2. Please use this form to report potholes.
4. Location of Pothole (Address or cross streets)*
6. Additional Description:
8. Date issue was observed (00/00/00)*
10. Upload a photo related to this issue:
12. Your Name*
14. Your email address*
16. Your phone number/extension*
18. For questions or additional information please contact the City Corporation Yard at (408) 776-7333.
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20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

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