Residential Cart Service Request - Milpitas Sanitation

Which service are you requesting?:

Start service date: *

Service Address: *

Address Line 1

City

State

Zip Code

Mailing / Billing address - if different from service address:

Address Line 1

City

State

Zip Code

Name(s) on account (Only these names may authorize changes to account): *

First

Last

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

Please supply at least one phone number (work):

Please supply at least one phone number (home):

Please supply at least one phone number (cell):

Do you own or rent the property that you are starting service for?: *

Own
Rent

DEPOSIT: Milpitas Sanitation requires a deposit equal to the amount charged for 3 months (1-quarter) of service. The deposit will be applied to your final bill.

If you previously had service with us, please list your previous Milpitas address:

Address Line 1

City

State

Zip Code

Note: A stop service application must be completed to stop service at this address or the account will remain active. *

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

Garbage / Food Scraps split cart size at the service location: *

EXTRA SMAILL - 19-gallons for garbage and 19-gallons for food scraps existing (64-gallon cart with insert)
SMALL - 26-gallons for garbage and 19-gallons for food scraps existing (64-gallon cart with insert)
MEDIUM - 45-gallons for garbage and 19-gallons for food scraps existing (64-gallon cart)
LARGE - 67-gallons for garbage and 29-gallons for food scraps existing (96-gallons cart)
None - I am having a cart delivered

Click here for a diagram of cart sizes.

Garbage / Food Scraps split cart size would you like delivered: *

EXTRA SMALL - 19-gallons for garbage and 19-gallons for food scraps existing (64-gallon cart with insert)
SMALL - 26-gallons for garbage and 19-gallons for food scraps existing (64-gallon cart with insert)
MEDIUM - 45-gallons for garbage and 19-gallons for food scraps existing (64-gallon cart)
LARGE - 67-gallons for garbage and 29-gallons for food scraps existing (96-gallons cart)
None - I am keeping the existing carts at site

Click here for a diagram of cart sizes.

Recyclables split cart and Yard Trimmings carts are included in the basic collection service prices. The standard sizes delivered with the Garbage / Food Scraps split carts are a 96-gallon Recyclables split cart and a 96-gallon Yard Trimmings cart. If you would prefer a smaller (64-gallon) split cart for Recyclables, please indicate below or request to have a customer service representative call you and discuss the sizes available. *

Deliver a 96-gallon recyclables split cart and a 96-gallon yard trimmings cart
Deliver a 64-gallon recyclables split cart
Please have customer service call me to discuss sizes

Click here for a guide of what belongs in your Garbage / Food Scraps spilt cart, Recyclables split cart, and Yard Trimmings carts.

Phone

There is a senior low-volume rate available for senior citizens (for 19 & 29-gallon Garbage/Food Scraps split carts only. Senior Rate form can be found here.

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 box to continue).

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 box to continue).

Click here for Rates for Service.

Form of payment for deposit: *

Mail check to office (1080 Walsh Avenue, Santa Clara, CA 95050)
Pay by credit card (Visa, MasterCard or Discover)

Phone number for customer service to call for credit card number.

The credit card will be charged for the 3-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).

Additional comment / questions: