Pallet-Load Recycling Supplies Order Form

Please fill out Order Form.

Date:   (MM/DD/YYYY)   WM Rep Name or ID:
 
SHIP TO:   BILL TO: Same as Generator Not Same
*BUSINESS NAME:
*ADDRESS:
*CITY
*STATE:
*ZIP:
*BUSINESS CONTACT:
*PHONE #:
FAX #:
P.O. #:
*Submitter's Name:
  
*BUSINESS NAME:
*ADDRESS:
*CITY
*STATE:
*ZIP:
*BUSINESS CONTACT:
*PHONE #:
FAX #:
*EMAIL ADDRESS:
* Required Fields

Outbound shipping charges will be added to order. Additional cost for special delivery instructions.

Qty Item Cost Description Typical Usage
B24 $75.00 plus shipping Bundle of 10 two foot 24"x24"x24" lamp boxes each box holds 48 t-12 utubes or 80 400w HID bulbs
B48 $45.00 plus shipping Bundle of 10 four foot 8"x8"x48" lamp boxes each box holds 64 t-8 lamps
B96 $75.00 plus shipping Bundle of 10 eight foot 7.5"x7.5"x96" lamp boxes each box hold 56 t-8
SD55 $100.00 plus shipping 55 Gallon UN1A2 Steel Drum open head steel drum w/lid, reconditioned, holds ballasts/batteries
GB424242 $40.00 plus shipping 42"x42"x42" Ballast Gaylord 750 lbs. Fluorescent Ballast (non-pcb only)
GE424242 $40.00 plus shipping 42"x42"x42" E-Scrap Gaylord Computers and e-scrap
Special Instructions
Type "I AGREE" in the signature box below.

*Signature:
*Name:
*Phone
*Email


Please complete the Order Form and press submit



 
Request a Quote Order a Pickup Request Packaging Supplies Packaging Instructions Acceptable Wastes Terms and Conditions