HHW Service Request Form

HHW Service Request Form

Let us know how we can help you!
Full Name*

First NameLast Name
Contact Number*
Please enter a valid phone number.
Email Address*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Notes
How did you hear about us?
Provide an estimate of items that will be left out on the collection date

Check the boxes of items that you may have. The products listed are the most common, but not the entire list of acceptable items
Oil based Paints / Flammable Oils

OilChromium based paintsShellacWater or driveway sealerOil based stainVarnish
Household Cleaners

BleachAmmoniaMuriatic AcidPool cleanersDrain CleanersSolventsPaint striper or thinner
Bulbs / Batteries

Fluorescent bulbsCFLNicadLithiumLead AcidAutomotiveMarine and sump pump batteries
Aerosols

Spray paintHairsprayWD-40Air freshenersSpray adhesivesOven cleanerInsecticide spray
Automotive Fluids

AntifreezeBrake or transmission fluidGasolineDieselMotor oil
Pesticides / Fertilizers

PoisonLawn chemicalsWeed killer
Other:
*Disclaimer: Call Clean Harbors at (866) 466-5060 to make your payment. Your HHW pick-up will not be scheduled until your payment is processed.
Should be Empty: