2. Waste Collection Business Hours are Monday through Friday, 7 a.m. to 4 p.m.

   Contact Numbers:

   Phone: 937-333-4948

   Phone: 937-333-TRSH

   Fax: 937-333-4816

   
   

   Contact Person: John Parker

   *Request must be submitted at least two weeks before the event is scheduled to occur*

4. Name of Person/Organization Requesting Services
6. Contact Name
7. Phone Number
9. Type of Event
11. Date/Dates of Event*
    Date/Dates of Event Start Date

    Date/Dates of Event Start Time

    —

    Date/Dates of Event End Date

    Date/Dates of Event End Time

    Request must be submitted at least two weeks before the event is scheduled to occur.

    
    

13. Location of Event*
14. Number of Containers Requested
16. Delivery Location of Containers
    Be specific.
18. Containers are needed by what time/date?
    Containers are needed by what time/date?

    Containers are needed by what time/date?
20. Date and Time for Collection of Containers
    Date and Time for Collection of Containers

    Date and Time for Collection of Containers
22. Special Accommodation Request
Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field