Customer Care Sheet
Name of Business:
Address:
City: State: Florida Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Country: USA Zip Code:
Landmarks or Cross Streets:
Contact Person: Title:
Office Phone: Fax:
Emergency Contact and Phone:
Email Address:
Office Hours:
Closed for Lunch? Select Yes No If yes what time?
Hours/Days not available:
FEIN# or SSN#(required if a LLC or Sole-Proprietorship):
D.O.H. Generator Control#:
Pick-up:	Weekly Bi-Weekly Every 28 Days Quarterly Semi-Annual
Size of Box:	15 Gallon Box (up to 25 lbs.) 30 Gallon Box (up to 40 lbs.) Tote (up to 500 lbs)