CVSan Single Family Cart Service Request -

PLEASE NOTE! THIS FORM IS FOR THE CITY OF CASTRO VALLEY SERVICE ONLY. ARE YOU USING THE CORRECT SERVICE AREA FORM?

YES - MY SERVICE ADDRESS IS IN THE CITY OF CASTRO VALLEY SANITARY DISTRICT (CVSAN). *

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

If you need to request services for a location in another one of our collection areas, please DO NOT USE this form. Please select the correct area below.

Unsure which service area is yours? CONTACT US

ALAMEDA SAN LEANDRO SAN RAMON

Which residential service are you requesting? *

Single Family Resident - Carts at site
Single Family Resident - Carts to be delivered

*Multi-Family Building with 5 or more units please contact us.

State service date: *

Service address (CVSAN ONLY): *

Address Line 1

City

State

Zip Code

PLEASE NOTE! THIS FORM IS FOR THE CVSAN SERVICE ONLY. If you need to request services for a location in another one of our collection areas, please DO NOT USE this form. Please select the correct area below.

Unsure which service area is yours? CONTACT US

ALAMEDA SAN LEANDRO SAN RAMON

Mailing / Billing address - if different from service address:

Address Line 1

Address Line 2

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

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

Address Line 1

City

State

Zip Code

Note: If you have an existing ACI account and need to close it, please list the address AND complete a stop service application. This must be completed to stop the 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: *

Click here garbage cart sizes/dimensions.

Recyclables and Organics are included in the basic collection service prices. The standard sizes delivered with the garbage carts are a 64-gallon recyclables cart and a 64-gallon organics cart. If you would prefer a smaller (32-gallon) or larger (96-gallon) cart for recyclables or organics, please indicate below or request to have a customer service representative will call you and discuss the size available.

Deliver a 64-gallon recyclables cart and a 64-gallon organics cart
Deliver a 32-gallon recyclables cart
Deliver a 96-gallon recyclables cart
Deliver a 32-gallon organics cart
Deliver 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. PLEASE NOTE: delivery, repair, or replacement of carts shall be provided on the Customer's next regular collection/service date. *

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

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 of Service

Form of payment for deposit: *

Mail check to office (610 Aladdin Avenue, San Leandro, CA 94577)
Pay by credit card (VIsa, American Express, MasterCard or Discover)

Phone number for customer service to call for credit card number:

The credit card will charged for the 3-month service deposit. It will NOT be charged for ongoing fees. DO NOT include credit card information with this form. Any forms received with credit card information will immediately be deleted and the application will not be processed. *

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

By having services and/or an account with ACI, 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 *

Clear Signature

Submission of this form must include a signature.

Additional comment / questions;

Castro Valley Sanitary District (CVSan) Single Family Cart Service Request

* = Required Information