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2. If you already have a City Utility Account, you can use this form to request additional garbage/recycle cans or removal of unwanted garbage/recycle cans.

   ***To request replacement or exchange of a can broken by regular use, call 801-766-9793 x 100.

   ***To replace cans lost, stolen, or damaged by misuse, contact Republic Services at 801-785-5935.

4. Name*
5. Email Address*
7. Utility Account #*
8. Date of Birth*
10. Service Address*
11. Phone Number*
13. I request:*

    1. removal
    2. delivery
14. # of cans:*

    1. 1
    2. 2
    3. 3
15. can type:*

    1. garbage can(s)
    2. recycle can(s)
17. Per New City Policy:*

    1. Agree

    By checking the above box, you agree that any additional Garbage or Recycle can(s) that are delivered must be kept for a minimum of 1 YEAR or a $100 per can removal fee will be added to your utility billing.

19. Agreement:

    Removal: I agree to place the *EMPTY* can(s) for removal at my curb no later than 7 a.m. on the Monday following successful submission of this form. If the can is not removed that day, I will place the can for removal on Thursday. (Note: Requests must be received no later than 4 pm on the Friday prior to delivery date. Requests received after that time will be honored the following week.) 

    Delivery: I agree to pay an additional monthly fee for the can(s) requested (Effective January 1, 2022: $15.15 per garbage can/$4.50 per recycle can). 

    New City Policy: Any additional Garbage or Recycle can(s) that are delivered must be kept for a minimum of 1 YEAR or a $100 per can removal fee will be added to your utility billing.

    Type Your Name Below (By typing your name and clicking the Submit button below you agree to the terms listed above):

21. First & Last Name*
Leave This Blank:


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

    This field is not part of the form submission.

25. Submit Submit and Print

* indicates a required field