Lamp Recycling | Lamp Disposal | Chemical Disposal | Waste Hazarous Non-Haz Universal | Ballast Recycling | Ballast Disposal | Transformer Recycling | Transformer Disposal

Download our Lamp Pick-Up Form PDF to fill out and fax back to us.

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LAMP PICK-UP FORM

* Email, phone and both name fields are required!!!

Date		Generator
*Contact First Name		*Contact Last Name
Address		City
State		Zip
*Phone		Fax
Cell Phone		*Email
EPA ID# (IF REQUIRED)		PO Number

JOB SPECIFICS:
NOTE: A temporary fuel surcharge will be added.
Quantity of Lamps	Number of Boxes	Number of Pallets	Lamp Type
			Fluorescent 4' & Less
			Fluorescent 5' & Over
			U-Tubes / HID Lamps
			Fiber Drums
			Other
**PLEASE RETURN ALL EMPTY BOXES DELIVERED TO AVOID CHARGES

Loading Dock	yes No	Lift Gate Necessary	yes No (LIFT GATE FEE MAY APPLY)
Pick Up / Delivery Hours

CONTRACTOR INFORMATION:
Contractor Name		Contact
Address		City
State		Zip
Phone		Cell Phone

WASTE PICK UP LOCATION:
Contact		Address
City		State
Zip		Phone
Cell Phone

Directions for Driver
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