Required fields are marked with asterisks (*)

Utility Account Information

Commercial Solid Waste Collection Service Request

Utility account number

Business name

Contact name

Business address

Alternate contact

Phone number

Alternate phone number

Email address

Bin size dimensions

Bin size	Dimensions (height x depth x width)
1.5 cubic yards	50" x 28" x 56"
3.0 cubic yards (both solid waste and cardboard)	57" x 45" x 56"

Bin size requested

1.5 cubic yard garbage bin

3.0 cubic yard garbage bin

3.0 cubic yard cardboard bin

Pick up frequency requested

1 pick up/week

2 pick ups/week (max for cardboard p/u, Tuesday and Friday only)

3 pick ups/week

4 pick ups/week

5 pick ups/week

Do you require a chain and lock?

Yes

Is this request for a multi-unit dwelling or apartment facility?

Yes

For additional information, contact Environmental Utilities at 403-529-8176

Preferred pick up day(s)

Monday

Tuesday

Wednesday

Thursday

Friday

Comments

Service Duration Disclaimer

The minimum commercial waste collection service period is four months. If service is cancelled prior to four months, a fee may be applied to the utility account for the commercial bin removal.

Customer authorization

By submitting this application/form you acknowledge and agree that any electronic signature provided by you herein is the same as a handwritten signature for the purposes of legality, validity, enforceability, and admissibility.

Signature

Clear

Date signed

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