• Internal Customer Form

    Internal Customer Form

    Please fill out the information below.
  • Are they a Returning Customer?*
  • Is this Service for a New Address or Existing?*
  • Is a Customer Agreement Required?*

  • Customer Information

  • Format: (000) 000-0000.
  • Is there a different billing contact?*
  • Format: (000) 000-0000.
  • Is the Service Address the same as the Billing Address?
  • Choose your bin service:
  • Please select your bin drop date:*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Please select your pickup date:*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Please select your exchange date:*
     - -
    2 digit month, 2 digit day, 4 digit year

  • Material Type

  • Select waste material being collected:*
  • Do you have a disposal site for your manure?*
  • What does your Demolition/Reno waste contain?*
  • What does your Recyclable Material contain?*
  • What does your Roofing Material contain?*
  • What does your Rubble/Soil Material contain?*
  • What does your Wood Product contain?*
  • Is this going to Sooke?*
  • What is this being dumped on?*
  • Did customer ask for a specific dump site?*

  • Your Asbestos or Leachable Lead Containing material.

  • What hazardous material is this?*
  • Homeowner or Professionally Remediated?*
  • Will a manifest need to be made by DL Bins?*
  • How is the asbestos containing material being contained?*
  • Is the load over 1,000kg?*
  • Is this a Hot Load or a Bin Drop?

  • Brush & Yard Waste.

  • What specific material is being disposed?*
  • 0/40
  • Are there any materials that did not originate in the outdoors such as treated wood products, metal or garbage?*
  • Does this material contain any potentially hazardous material such as drywall, concrete, painted wood, stucco or other from before 1991?*

  • Demo/Reno Material.

  • What kind of material is this?
  • Is the building before 1991?*
  • Is there documentation showing of a post-1991 renovation/abatement?*
  • Is this a Hot Load or a Bin Drop?*

  • Organic Material.

  • Are there any non-organic materials contained in the load?*
  • Does this material contain any potential hazardous materials such as drywall, concrete, painted wood or stucco from before 1991?*

  • Garbage material.

  • Does your Garbage contain any of these banned materials: Aerosols, Chemicals or Pesticides?*
  • Does your Garbage contain any potential hazardous materials such as drywall, concrete, painted wood or stucco from before 1991?*

  • Cardboard & Paper material.

  • Are there other materials comingled with your Cardboard & Paper such as garbage, plastics or glass?*
  • Does this mixed material contain any potential hazardous materials such as drywall, concrete, painted wood or stucco from before 1991?*

  • Metal Material.

  • Are there any other materials comingled with your Metal such as garbage, plastics or glass?*
  • Does this mixed material contain any potential hazardous materials such as drywall, concrete, painted wood or stucco from before 1991?*

  • Asphalt Shingles material.

  • Do your Asphalt Shingles contain any other material than Shingles, Tar Paper or Roofing Nails?*
  • Does this mixed material contain any potential hazardous materials such as drywall, concrete, painted wood or stucco from before 1991?*
  • Select total roof area being removed (double the area if there are 2 layers of roof):

  • Note: Under 38SQ Roofs we use 12Y High, anything over 39SQ Is a large 20, 30Y or 40Y

  • Cedar Shakes material.

  • Are there any other materials mixed in with the wood?*
  • Is there any enamel paint on the surface of the wood?*
  • Does this mixed material contain any potential hazardous materials such as drywall, concrete, painted wood or stucco from before 1991?*

  • Soil material.

  • Is there anything other than soil in the material?*
  • How many Yards of Soil needs to be disposed?*

  • Note: 8Y Bins can hold up to 3 Yards, 18 and Large 20's can hold up to 10 Yards. Do not send any other bin.

  • Rubble/Concrete/Tile Materials.

  • What is being disposed of?*
  • What kind of concrete is it?*
  • Is there a date stamp after 1991 on the drywall?*
  • Does your waste contain anything such as paint, mortor, stucco or mesh?*
  • Are these items from before 1991?*

  • Clean Wood material.

  • Are there any other other materials than wood?*
  • Does this mixed material contain any potential hazardous materials such as drywall, concrete, painted wood or stucco from before 1991?*

  • Painted/Treated Wood material.

  • Are there any other other materials than wood?*
  • Is there any enamel paint on the surface of the wood?*
  • Is the house from before 1991, or is there documentation to show this material is post 1991?*
  • Does this mixed material contain any potential hazardous materials such as drywall, concrete, painted wood or stucco from before 1991?*

  • 'Other' Material.

  • Drop off, or Hotload?*
  • Will there be any potentially hazardous materials in the load?*

  • Material Testing

  • Has the material been tested and has documentation?*
  • Was the material found to contain unacceptable levels of lead, asbestos or other?*

  • Other Roofing Material

  • What is the material?*
  • Is the Gravel on the roof clean, or comingled with the tar/other items?*

  • Manure

  • Will this need to be dumped on a rotational basis?*
  • How often does this need to be dumped?*

  • Bin specifics:

  • Choose a mini-bin size (4 Ton maximum):
  • Or, choose a large bin size (10 Ton maximum):

  • Fees and Submission.

  • Informed of 1 Tonne Minimum?
  • Informed of 7 Days Free Rental?
  • Should be Empty: