Residential Cart Service Request

Which residential service are you requesting?: *

Single Family Resident - Carts at site
Single Family Resident - Carts to be delivered
Multi-Family Resident - Carts at site
Multi-Family Resident - Carts to be delivered
Unincorporated County Resident** - Carts at site
Unincorporated County Resident** - Carts to be delivered

**Unincorporated residential densely populated areas include: Residents living on Buena Vista Avenue, Calvary Lane, Edwards Avenue, Marina Avenue, Pleasant View Lane, and Reed Lane.

Start service date: *

Service address: *

Address Line 1

City

State

Zip Code

Mailing / Billing address - if different from service address:

Address Line 1

City

State

Zip Code

Name(s) on account (Only these names may authorize changes to account): *

First

Last

Name(s) on account (Only these names may authorize changes to account):

First

Last

Name(s) on account (Only these names may authorize changes to account):

First

Last

Please supply at least one phone number: (work)

Please supply at least one phone number: (home)

Please supply at least one phone number: (cell)

Email *

Do you own or rent the property that you are starting service for?: *

Own
Rent

Deposit: LSI requires a deposit equal to 3 months (1-quarter) of service for all customers. The deposit will be applied to your final bill.

If you previously had service with us, please list your previous Livermore address:

Address Line 1

City

State

Zip Code

Note: A stop service application must be completed to stop service at this address or the account will remain active. *

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

Garbage collection cart size at the service location: *

Garbage collection cart size would you like to have delivered: *

Recyclables and Organics are included in the basic collection service prices. The standard sizes delivered with the garbage carts are a 96-gallon recyclables cart and a 96-gallon organics cart. If you would prefer a different size cart for recyclables or organics, a customer service representative will call you and discuss the size available.

Deliver a 96-gallon recyclables cart and a 96-gallon organics cart
Please have customer service call me to discuss sizes available

Phone number:

There is a charge to change your service level more than once in a twelve-month period - please call our office for fee information. *

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

Rate for Service. I have read the rate sheet / misc. rate sheet and acknowledge the rate for this service. I understand that service cannot begin without acknowledgement of the applicable service rate. *

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

Click here for Rate for Service .

Form of payment for deposit: *

Mail check to office
Pay by credit card (Visa, MasterCard or Discover)

Phone number for customer service to call for credit card number

This credit card will be charged for the 3-month service deposit. It will NOT be charged for ongoing fees. *

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

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.

Additional comment/questions:

*Required