Service Order Annual 2 can

OC CleanACan Service Area:*

Have you used our services before?*

Best Contact #:*

Area Code & Phone Number

Type of Contact #:*

Home PhoneCell Phone

E-mail:*

Trash Collection Day:*

Please use the fields below to tell us what types of cans will be cleaned & the quanity.

Regular Trash:*

Enter can amount

Recycle:*

Enter can amount

*Yard Waste:*

Enter can amount

*NOTE: A $6 per month surcharge ($72 Annually) will be manually added for each Yard Waste container as these cans require more time and resources to clean. This may reflect as separate charge on your credit card.