City of San Leandro Debris Box Service Request

* = Required Information

To request Debris Box Service in the city of San Leandro please complete all the required information below and submit.

If you are unable to complete or submit this form, please call us at 510-357-7282.

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I acknowledge that the services I am requesting are for an address in the CITY OF SAN LEANDRO.

If you need to request services for a location in another one of our collection areas, please do not use this form. Select the correct area. Thank you. ALAMEDA   CVSAN   SAN RAMON
Customer name:
Site address:
Billing address:
Please be specific with start date and estimated end date
California state ordinance SB1383 requires that divertible materials such as recyclables (bottles, cans, metals, paper, cardboard and glass) and organic materials (yard trimmings and food scraps) be separated from other municipal solid waste.
How will you ensure compliance with the ordinance(s) listed above?

PLEASE NOTE: If you choose that you will not be generating any recyclable or organics materials, you will be contacted by ACI to confirm status.
Note: No Hazardous Waste allowed in box. Material cannot be higher than edge of box. Do not overfill box.
Debris box size:
Debris box material (choose all that apply):
Your account will be charged the rate for loose garbage if the landfill determines your C&D load(s) are contaminated. Also, note that the City of San Leandro requires that C&D tonnage be reported on GreenHaloSystems.com. ACI will provide the necessary tonnage reports upon request.
Debris box location:
All debris box customers will be required to pay a pre-payment per box per pull. Pre-payment is equal to the delivery/placement fee and the per pull charge for the size/material debris box requested.
I have read the billing and service guidelines. We will not be able to start your service until you acknowledge these guidelines. Billing includes: A placement fee, per pull charge and tonnage charge for each pick up or attempt to pick up. If the container is not picked up within seven days, a demurrage charge will be applied each day unit service is scheduled. PLEASE NOTE: Highly contaminated boxes will be serviced as garbage or may not be serviced at all.
I have read the list and will not dispose of any hazardous waste items in any Alameda County Industries collection cart or bin. We will not be able to start your service until you acknowledge this notice.
I have read the liability waiver. We will not be able to start your service until you acknowledge the liability waiver.
Liability waiver name:
Liability waiver site address:
Upon request, ACI will provide tonnage reports.
Your account will be charged the rate for loose garbage if the landfill determines your C&D load(s) are contaminated.
By having services and/or an account with ACI, you agree to our General Information, Terms, and Conditions.
By having services and/or an account with ACI, you agree to our General Information, Terms, and Conditions.
Clear Signature
Submission of this form must include a signature.
By submitting this form, I acknowledge I have ready all required guidelines and the liability waiver.