2. Special Pick-Up Request Form

4. This form allows residents to request a special pick-up for items not covered by regular waste collection services, such as large furniture or appliances. Please provide your contact information, and the details of the items to be collected. Our team will review your request and schedule the service accordingly.

6. Name of Account Holder*
8. Pick Up Address*
10. City*
11. State*
12. Zip*
14. Contact Number*
16. Items to be Collected*
Leave This Blank:


18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field