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2. Select All That Apply:

   1. I do not have and want a 95-gallon recycling cart
   2. I do not have and want a 65-gallon recycling cart
   3. I have a 95-gallon recycling cart and want a 65-gallon cart
   4. I have a 65-gallon recycling cart and want a 95-gallon cart
   5. I have a recycling cart, but it is damaged or missing parts
   6. I have bulky waste for pickup

   1. I have brush/yard waste for pickup
   2. I have both bulky and brush/yard waste for pickup
   3. My trash was not picked up
   4. My recycling was not picked up
   5. I have a question about recycling
   6. I have a question about trash
4. First Name*
5. Last Name*
7. Address*
9. Apartment number or letter
11. Gate or access code
13. City*
14. State*
15. Zip Code*
17. Phone Number
19. Email Address*
21. Bulky Waste and/or Bulky Brush Pickup Description (if applicable)

    Please provide a brief description of the type of waste you are requesting pickup for. Note: bulky brush pickup is charged $136.51 per hour.

23. Type in your recycling question (if applicable):
25. Type in your trash question (if applicable):
Leave This Blank:


27. Submit Submit and Print

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