Quote Request Form for Pallet Load Recycling

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Quote Entry Date:
WM Rep Name or ID:

Customer/Billing Information:

 *Business Name:
 *Street Address:
Billing Contact:
 *Phone Number:
   Fax Number:
 *Email Address:

Pickup Site Information:

Pickup Location:   Same as Billing Location   Not Same
 *Business Name:
 *Street Address:
Pickup Contact:   Same as Billing Contact  Not Same
 *Phone Number:
   Fax Number:
 *Email Address:

All materials must be properly packaged in sealed containers, palletized and shrink-wrapped.
Click on this link to view our packaging instructions:
Note in Special Instructions below if your materials include any waste items that will need to be removed from a product, device or consumer packaging.

Materials to Pickup:

Lamps: Enter Quantity Estimated Weight
For Shipment
• Straight tubes - 1 foot count lbs
• Straight tubes - 2 foot count lbs
• Straight tubes - 3 foot count lbs
• Straight tubes - 4 foot count lbs
• Straight tubes - 5 foot count lbs
• Straight tubes - 6 foot count lbs
• Straight tubes - 7 foot count lbs
• Straight tubes - 8 foot count lbs
• Ubent tubes count lbs
• Circular tubes count lbs
• CFLs countlbs
• HIDs (mercury, halide, sodium) count lbs
• LED lamps count lbs
• Other whole bulbs count lbs
• Incidentally broken lamps drums lbs
• Intentionally crushed lamps drums lbs
Lighting ballasts: count lbs

• Cell phones lbs
• TVs and Monitors lbs
• Tower, Desk, & Laptop computers lbs
• Servers lbs
• eScrap(printers, keyboards, mice, peripherals, wire) lbs

• Alkaline lbs
• Lead Acid lbs
• Nickel lbs
• Lithium Ion (rechargeable) lbs count
• Lithium Metal (non-rechargeable) lbs count
Mercury Devices & Equipment: lbs  
Other Items:
Special Instructions:

Please also note in Special Instructions above if a lift gate will be required; if labor will be required for packaging, palletizing or loading; if pickup is at a limited or difficult access site such as a residence, school, church, hotel, storage unit, construction site, unstaffed site, military base or guarded site; or if the pickup involves hazardous waste that contains PCB Ballasts or Crushed Lamps.

  • First and Last Date Available/Requested for Pickup * to *
  • Available Pickup Hours * to *

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