Multi-Family Annual Clean Up Request

Multi-Family Annual Clean Up Service Request

*Required

To request Multi-Family Annual Clean Up Service please complete all the required information below and submit.

PLEASE NOTE: ONLY THE BUILDING OWNER OR MANAGER CAN REQUEST THIS SERVICE.

If you are unable to complete or submit this form, please call us at 925-449-7300.

Customer name: *

First

Last

Email *

Company / Owner Name:

Site address: *

Address Line 1

City

State

Zip Code

Site phone number: *

Service is for a 20-yd Debris Box: Debris Box dimensions are: 18.0' long x 8.0' wide x 4.0' high

Requested delivery date: *

Removal will be automatically scheduled for seven (7) days after delivery date. Earlier removals can be requested at no additional cost.

PLEASE REMEMBER: NO HAZARDOUS WASTE, AUTOMOTIVE PARTS OR TIRES, MATTRESSES OR BOX SPRINGS, DIRT, BRICK, CEMENT, OR STUCCO IN BOX. DO NOT OVERLOAD. DO NOT FILL BOX ABOVE WATER LINE. *

I acknowledge the above statement (please check box to continue)

Place in: *

Street
Driveway
Other (explain below)

If Debris Box is to placed in a location other than the street or driveway. Please describe location in detail:

I have read the service guidelines and acknowledge the rate for this service. I understand that service cannot begin without acknowledgement of these guidelines.. *

I acknowledge the above statement (please check box to continue)

Click here for Multi-Family Annual Clean Up Service Guidelines .

I have read the list and will not dispose of any hazardous waste items in any Livermore Sanitation collection cart or bin. We will not be able to start your service until you acknowledge this notice. *

I acknowledge the above statement (please check box to continue)

Click here for Hazardous Waste Policy Notice .

I have read the liability waiver. We will not be able to start your service until you acknowledge the liability waiver. *

I acknowledge the above statement (please check box to continue)

Click here for Liability Waiver .

Liability waiver name: *

Liability waiver site address: *

Address Line 1

City

State

Zip Code

By having services and/or an account with LSI, you agree to our General Information, Terms and Conditions. *

I acknowledge the above statement (please check box to continue)

Click here for our General Information, Terms and Conditions.

Signature:

Submission of this form must include a signature.

By submitting this form I acknowledge I have read all required guidelines and liability. *

I acknowledge the above statement (please check box to continue)

Name