Unincorporated County Rural Resident Cart Service – Carts to be Delivered

To request an Unincorporated County Resident Start Cart - Carts to be Delivered please complete all required information below and submit.

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

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)

Email *

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

Own
Rent

Deposit: LSI requires a deposit equal to 3 months (1-quarter) of service for all customers. The deposit will be applied to your final bill.

If you previously had service with us, please list your previous Livermore 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 collection cart size at the service location: *

Garbage collection cart size would you like to have delivered: *

Recyclables are included in the basic collection service prices. The standard size delivered with the garbage carts is a 96-gallon recyclables cart. If you would prefer a different size cart for recyclables, a customer service representative will call you and discuss the size available.

Deliver a 96-gallon recyclables cart
Please have customer service call me to discuss sizes available

Phone number:

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 Rate for Service.

Form of payment: *

Mail check to office
Pay by credit card (Visa, MasterCard or Discover)

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

This credit card will be charged for the 3-month service deposit. It will NOT be charged for ongoing fees. *

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

Unincorporated County Rural Resident Start Cart Service
– Carts to be Delivered Request Form

*Required

Unincorporated County Rural Resident Start Cart Service – Carts to be Delivered Request Form

*Required

Unincorporated County Rural Resident Start Cart Service
– Carts to be Delivered Request Form