San Leandro Multi-Family 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

Which residential service are you requesting?: *

Multi-Family building bin service (buildings with 5 units or more)*

*Multi-Family Buildings with 4 units or less require a Residential Cart service request form.

State service date: *

Site address: *

Address Line 1

City

State

Zip Code

Site email: *

Site phone number: *

Billing address: *

Address Line 1

Address Line 2

City

State

Zip Code

Billing phone number: *

Billing email: *

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

Deposit equal to one month’s service is required AND IS NOT BILLABLE. This is required for each bin depending upon amount of service. Deposit is refundable when account is closed and balance paid. We accept company check, money order, credit card (Visa, American Express, MasterCard & Discover) or cash (no third-party checks). *

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

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 be charged for the 1-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).

Multi-Family garbage collection BIN size: *

Mixed garbage collection service frequency: *

There is a per dwelling unit charge for Recyclables collection and no charge for basic Organics service. These services are provided using 96-gallon carts. Please note that recycling is mandatory in Alameda County. If recyclables and organics service is not already in place on your property, we invite you to contact us today and get started. *

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

If you would prefer a different size cart for recyclables or organics, a customer service representative will call you and discuss the size available.

Phone number:

Please have customer service call me to discuss sizes available.

Multi-Family mixed recyclables collection CART size: *

32-gallon cart
64-gallon cart
96-gallon cart
None - I am requesting MIXED RECYCLABLES BIN service

Multi-Family mixed recyclables collection BIN size: *

Mixed recyclables collection service frequency: *

1x week
2x week (requires ACI review and approval)
3x week (requires ACI review and approval)
4x week (requires ACI review and approval)
5x week (requires ACI review and approval)

Multi-Family organics (food/yard waste) collection cart size: *

32-gallon
64-gallon
96-gallon

Multi-Family organics (food/yard waste) collection service frequency: *

1x week
2x week (requires ACI review and approval)
3x week (requires ACI review and approval)
4x week (requires ACI review and approval)
5x week (requires ACI review and approval)

IF THE DRIVER DOES NOT HAVE DIRECT ACCESS TO YOUR BIN(S) (on-premises collection option selected), PLEASE FILL IN THIS REQUIRED INFORMATION:

PUSH/PULL* This includes bringing the container to the curb and returning the container back to your property. LINEAR FEET:

(Distance from location that driver will dump bin, to location where bin is stored).

PUSH* This includes bringing the container to the curb after servicing. LINEAR FEET:

(Distance from location that driver will dump bin, to location where bin is stored).

PULL* This includes returning the container from the curb to your property after servicing. LINEAR FEET:

(Distance from location that driver will dump bin, to location where bin is stored).

*PLEASE CLICK HERE FOR RATE SHEET FOR FEES ON ABOVE SERVICES. NOTE THAT PUSH/PULL DISTANCE WILL BE VERIFIED BY AN ACI SUPERVISOR. ALSO, NOTE THAT THERE IS NO CHARGE FOR ON-PREMISE SERVICE OF CARTS. DEPOSIT EQUAL TO ONE MONTH'S SERVICE FEE IS REQUIRED AND IS NOT BILLABLE.

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 to continue).

Click here for Rate of Service

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 to continue).

I have read the billing and service guidelines. We will not be able to start your service until you acknowledge these guidelines. *

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

Click here for Multi-Family (9 units or more) 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

By having service 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 or our General Information, Terms, and Conditions.

Signature: *

Clear Signature

Submission of this form must include a signature.

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

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

Additional comment/questions:

Multi-Family buildings with 5 units or more

City of San Leandro Multi-Family Bin Service Request

* = Required Information