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Email

Phone Number

Address

Preferred Date

Preferred Time Select time slot Morning (8:00 AM - 12:00 PM) Afternoon (12:00 PM - 4:00 PM) Evening (4:00 PM - 8:00 PM)

Waste Type Select waste type General Waste Recycling Organic Waste

Estimated Quantity Select quantity Small (1-2 bags) Medium (3-5 bags) Large (6+ bags)

Additional Notes

Waste Location Photo