Waste/Recycle Can request Form

First

Last

Address

Phone Number

Requested Cans Needed

Additional Recycle (blue can)

Replace Broken Recycle Can

Additional Waste Can (green can)

Broken Waste Can

Other…

I understand that, in the case of broken waste or recycling bin, I am required to place them at the curbside for waste management to replace.

Additional Notes for Utility Clerk

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