Solid Waste Request Form for Special Events
Recreation Services
Name of Event:
Event Start Date:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
End Date:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Event Location:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Point of Contact:
First Name
Last Name
Contact Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Contact Email:
example@example.com
Dumpster fees:
Set Fee
$110.00
Disposal Fee
$14.87
Dumpster size requested:
*
2 yard
3 yard
4 yard
6 yard
8 yard
How many for the 2 yard?
*
How many for the 3 yard?
*
How many for the 4 yard?
*
How many for the 6 yard?
*
How many for the 8 yard?
*
Location of Dumpster?
*
Roll-Off Dumpster Fees
Roll-Off Size
13 yard
20 yard
30 yard
40 yard
Set Fee
$134.00
$134.00
$134.00
$134.00
Roll-Off Pull Fee
$267.00
$267.00
$267.00
$267.00
Minimum Disposal Fee
$120.00
$375.00
$375.00
$375.00
Roll-off dumpster size requested:
*
13 yard
20 yard
30 yard
40 yard
How many for the 13 yard
*
How many for the 20 yard
*
How many for the 30 yard
*
How many for the 40 yard
*
Location of roll-off?
*
Additional Services
Residential Can (65 Gallon @ $24.04/can)
Cardboard Container ($14.87/can)
How many residential cans?
*
How many cardboard containers?
*
Will you be using an existing dumpster?
*
Yes
No
Where is the dumpster located?
*
Will you be requesting an additional dump?
*
Yes
No
Date and time for additional dump?
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
** Additional dumps will incur additional fees for disposal fee and/or operator time
If not using City of Prescott Solid Waste Services, What is your plan for solid waste (trash)?
Please provide plan:
Quantity of receptacles?
Company used for receptacles?
Quantity of Portable Toilets?
Company used for portable toilets
Please provide verification of service from non-city solid waste services (invoice, email, etc.)
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