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Trash Pickup Request Form

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Steps

1. Contact Information This section is complete This section is incomplete
2. Pick-up Information This section is complete This section is incomplete

Contact Information

Please complete the online form below to submit your request.
First Name
Last Name
Address1*
Address2
City
State
Zip
Phone Number*
Email Address*
Continue

Pick-up Information

Please indicate the type of missed pickup or other request. Check all that apply.(*at least one must be checked) *
Reminder: No yard waste in plastic bags. Bundles need to be tied.
1. Yard Waste
2. Trash
3. Bulky Waste(i.e. furniture, appliances or large items)
4. Other - Please describe below.
Other trash request
If "Other - Please describe below" is checked, provide detail description of request.
Trash Pick up Day*
Indicate your scheduled pick up day.