Debris Boxes Request Form

Contact Name*

Contact Phone Number*

Contact Email*

Delivery Street Address*

Delivery City*

Delivery Zip Code*

Business / Organization Name

Are you a current customer?

Yes
No

Customer number (if known)

Your customer number can be located on past statements.

Is this box for a construction site?*

Yes
No

Construction jobs: construction contractors and personnel acknowledge by signing this Agreement to be responsible for all charges identified within this Agreement.

Please indicate the approximate number of boxes anticipated to complete this project*

Please enter a number from 1 to 100.

Material types:*

Box size:*

10 cubic yards
20 cubic yards
30 cubic yards

Are you interested in a split box?

Yes
No
Unsure – I would like more information

Note, this option is for City customers only. Our split boxes are 20-yard boxes with a divider in the middle. You can choose any combination of these material types: wood, yard trimmings, drywall, metal, cardboard, single-stream recycling or trash.

Delivery/haul-in request date – preference #1

Note, delivery dates may be 3-4 business days out for our busy times.

Delivery/haul-in request date – preference #2

Comments / Delivery / Box Placement:

Please note, material placed on driveway may cause damage; all boxes must only be filled to water level.

Billing information same as delivery information?*

Yes
No

Billing Contact Name*

Billing Contact Phone Number*

Billing Contact Email Address

Billing Delivery Street Address*

Billing City*

Billing Delivery Zip Code*

Billing Business / Organization Name

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Phone

This field is for validation purposes and should be left unchanged.

Napa Recycling and Waste Services

Napa Recycling and Waste Services

Your guide to reducing, reusing and recycling, provided by Napa Recycling.

Debris Box Request