San Leandro Debris Box Service Request -

I acknowledge that the services I am requesting are for an address in the CITY OF SAN LEANDRO. *

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. Select the correct area. Thank you. ALAMEDA CVSAN SAN RAMON

PO#:

Customer name: *

First

Last

E-mail: *

Company / owner name:

Site address: *

Address Line 1

City

State

Zip Code

Site phone number: *

Site email: *

Billing address: *

Address Line 1

City

State

Zip Code

Billing phone number: *

Billing email: *

What is the expected length of the project? *

Please be specific with start date and estimated end date

Type of customer: *

How many employees/workers will be on site on a daily basis?

California state ordinance SB1383 requires that divertible materials such as recyclables (bottles, cans, metals, paper, cardboard and glass) and organic materials (yard trimmings and food scraps) be separated from other municipal solid waste.

How will you ensure compliance with the ordinance(s) listed above? *

The project will utilize existing on-site recyclable and organics collection capacity.
The project will utilize recyclable and organics debris box(es).
The project will need to set up weekly recycling and organics collection service for the duration of the project.
The project will self-haul recyclable and organic material to appropriate recycling site(s).
The project will not be generating any recyclable or organic material.

PLEASE NOTE: If you choose that you will not be generating any recyclable or organics materials, you will be contacted by ACI to confirm status.

Note: No Hazardous Waste allowed in box. Material cannot be higher than edge of box. Do not overfill box. *

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

Requested delivery date: *

Debris box size: *

10 yard debris box - for clean dirt, rock, brick, sod, and cement (PLEASE NOTE: dirt, rock, brick, sod, and cement cannot be combined with other Construction and Demolition materials and must be collected separately.}
15 yard debris box
20 yard debris box
30 yard debris box
40 yard debris box

Debris box material (choose all that apply): *

Your account will be charged the rate for loose garbage if the landfill determines your C&D load(s) are contaminated. Also, note that the City of San Leandro requires that C&D tonnage be reported on GreenHaloSystems.com. ACI will provide the necessary tonnage reports upon request. *

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

If the recyclable material collected is a single type, please list the material:

Debris box location: *

Street
Driveway
Other

Please list address / placement / other details here:

All debris box customers will be required to pay a pre-payment per box per pull. Pre-payment is equal to the delivery/placement fee and the per pull charge for the size/material debris box requested. *

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

Click here for Rate of Service.

I have read the billing and service guidelines. We will not be able to start your service until you acknowledge these guidelines. Billing includes: A placement fee, per pull charge and tonnage charge for each pick up or attempt to pick up. If the container is not picked up within seven days, a demurrage charge will be applied each day unit service is scheduled. PLEASE NOTE: Highly contaminated boxes will be serviced as garbage or may not be serviced at all. *

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

Click here for Debris Box Billing and Service Guidelines .

I have read the list and will not dispose of any hazardous waste items in any Alameda County Industries 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 ACI Liability Waiver .

Liability waiver name: *

First

Last

Liability waiver site address: *

Address Line 1

City

State

Zip Code

Do you have a completed ACI credit application on file?: *

Yes - acknowledge and submit
No - click link below

If you do not have a ACI Credit Application on file, please fill-out request from and submit. Click here to fill out ACI Credit Application.

Upon request, ACI will provide tonnage reports. *

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

Your account will be charged the rate for loose garbage if the landfill determines your C&D load(s) are contaminated. *

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).

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

Signature: *

Submission of this form must include a signature.

By submitting this form, I acknowledge I have ready all required guidelines and the liability waiver. *

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

City of San Leandro Debris Box Service Request

* = Required Information