Dumpster Service Request

Name

Address

Date requested

Please check one

Dump only leave dumpster I want to continue to use it.

Dump and Pick Up I am done with the dumpster.

Dumpster Fee and Pick-up Policy

I understand that the cost for the requested dumpster service is $80. Additionally, I acknowledge that if I request the dumpster to be picked up at the same time as the service, no additional fees will apply. However, if I choose to continue using the dumpster, I will incur additional service or pick-up fees for future requests.

I acknowledge that I have read and fully understand the Uintah City Dumpster Fee and Pick-up Policy. I understand my utility account will reflect these charges on my next utility statement.

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