Trash and Compost Service Sign up Form

Name*

First NameLast Name

In Care of (if applicable)

Service Address*

Street Address

Street Address Line 2

CityState

Zip Code

Full Mailing Address*

Email*

Phone Number*

Please enter a valid phone number.

Is This a rental Property?*

YesNo

Trash/Recycle Service - Select One if applicable

35 Gallon Can Collected 1X Per Month - $12.00/quarter20 Gallon Can - $48.00/quarter35 Gallon Can - $68.25/quarter64 Gallon Can - $96.00/quarter96 Gallon Can - $129.00/quarter160 Gallon Can - $168.00/quarter

Food Scrap Option:

Curbside Food Scrap Collection - $44.25/quarter

Required*

I understand and agree to the below statements

(1) I am electing service at the residence indicated above. (2) I agree to pay the fees as set by the Town of Mansfield and agree to abide by the Town’s Solid Waste Ordinance and Regulations. (3) Bills are mailed out quarterly in advance of service. (4) Owner occupied residences - I am responsible for recycling. Recyclables mixed in the trash may result in the trash not being taken or fines being issued. (5) Landlords - I am responsible for informing new tenants about what to recycle. Recyclables mixed in the trash may result in the trash not being taken or fines being issued. (6) Trash and recyclables should be placed by the road before 6 a.m. on the day of collection. (7) The containers are property of the contractor. The charge for a missing container is $100. Containers need to be returned at the time of service cancellation to avoid a missing container charge.