Waste Can Replacement / Change of Service Request

2. Today's Date:*
   Today's Date:
3. Account Number:*
4. Account Holder Name:*
6. Service Address:*
7. Garbage Pick Up Day:*
9. Phone Number:*
10. Email Address:*
12. Change Requested:*

    Please choose the type of change you are requesting. You may select more than one.

    Please Note:

    • When adding a can, service must be kept for at least 6 months.
    • When cancelling Green Waste, there is a $12 cancellation fee after the mandatory 6 month period.
    • Cans MUST be empty prior to replacements/cancellations
    • When requesting replacement, please upload image of damage if possible.

    1. Replacement Black Garbage Can
    2. Replacement Blue Recycling Can
    3. Replacement Green Waste Can

    1. Add 2nd Black Garbage Can ($14.30)
    2. Add 2nd Blue Recycling Can ($4.75)
    3. Add Green Waste Can ($6.00)

    1. Cancel 2nd Black Garbage Can
    2. Cancel 2nd Blue Recycling Can
    3. Cancel Green Waste Can ($12)
14. Image Upload

    Please upload image(s) of waste can damage here (if applicable)

16. Type of Damage

    Please describe the damage in as much detail as possible

18. Is Can Empty Now?*

    1. YES
    2. NO

    If can is not empty, please leave at the curb after your next garbage pick up day and Public Works will then replace the can.

20. Once form is submitted, we will respond within 2-3 business days with confirmation and/or further instructions.

    If you have questions, you may call us at 801-776-0970.

    Thank you!

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22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit

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