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2. Questions/Concerns submitted thru this online form will be sent to the City (for their awareness) and to Waste Management directly (for resolution). The City will not be following up with you unless requested in the description.
4. First Name*
5. Last Name*
7. Address1*
9. Address2
11. City*
12. State*
13. Zip*
15. Phone Number*
16. Email*
18. My Regular Day for Pickup Is:*

    1. Monday
    2. Tuesday
    3. Wednesday
    4. Thursday
    5. Friday
    6. Don't Know
19. Regarding: *

    1. Garbage
    2. Recycling
    3. Both
    4. Other
21. Description of Issue *
23. Upload a Photo Here if Applicable
Leave This Blank:


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

    This field is not part of the form submission.

27. Submit

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