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Once per Week Trash Collection (96 Gallon Toter w/brown lid) *up to 3 additional 30 gallon bags allowed

Once per Week Trash Collection (96 Gallon Toter w/blue lid) + Once per Week Recycling Collection (96 Gallon Toter w/green lid)

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Email Address*

Subdivision Name*

Address*

City, State & Zip*

State, Drivers License #*

Date of Birth*

Phone (Home)*

Phone (Work)

Phone (Mobile)

Mailing Address (If Different From Above)

City, State & Zip

Referred By

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Additional Comments

Terms & Conditions*

I have read the C6 Disposal Terms and Conditions

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Most contracts have automatic renewal clauses and require 60 days written notice sent certified mail in order to cancel.

If upon management's review a request for service is declined a refund may be available; otherwise no refunds will be given.