Intake Date and Time
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Who Is Completing This Form?
*
Please Select
Customer
Christensen Recycling Employee
How Can We Help You
*
Please Select
I Need Cats, Cores or Scrap Metal Picked-Up
I Need a Dumpster Delivered For Scrap Metal
I Need My Dumpster Swapped
I Need My Dumpster Picked Up
Looking To Buy Materials
Looking To Sell Materials
I Would Like Someone To Call me
Other
💬 What Would You Like to Discuss With Us?
Employee
*
Please Select
Rich
Luis
Alex
Andrew
Kenny
Outdoor Sales
Rene
Ken
Buyer - Then Told Office
Buyer - AA - Mobile
Buyer - ATJ - Mobile
Buyer - MS - Mobile
Buyer - TA - Mobile
Buyer - KF - Mobile
Buyer - RM - Mobile
Buyer - Other
Missed Call (Voicemail)
Other (Explain in Office Notes)
Request Source
*
Please Select
Outbound Call
Main Office Line
Buyer Cell Phone Direct
Ken Direct
Rene Direct
Rich Direct
Andrew Direct
Luis Direct
Website
E-Mail
Text Message
Outdoor Sales
Other (Explain in Office Notes)
Request Type
*
Please Select
Auto Repair Shop
Auto Body Shop
Auto Dealership
Midas - Corporate Owned
Midas - Individually Owned
Meineke - Corporate Owned
Meineke - Individually Owned
Catalytic Converter or Cores Price Quote - Give Ken's Email Address: kcautoscrap@aol.com
Turned Down Junk Car - Inquiry
Diesel Repair Shop / Fleet Service Center
Bus Company
Towing Facility
Scrap Yard
Warehouse / Industrial Account
Scrap Dumpster - Inquiry
Scrap Dumpster - Delivery For New Customer
Scrap Dumpster - Delivery For Repeat Customer
Scrap Dumpster - Swap
Scrap Dumpster - Pickup Only
Turned Down Garbage Dumpster - Inquiry
Garbage Dumpster - Pickup Only
Quote Request - Urgent Response Required
*****HIGH PRIORITY - Callback ASAP*****
Non-Revenue Call / Solicitation
Company Looking To Buy Our Scrap Metal Or Catalytic Converters
Negative Customer Feedback (Let Ken Know)
Call For Ken Directly (Explain in Office Notes)
Other - (Explain in Office Notes)
Company Name
*
Contact Name
*
Address (Street, Town, State - Type Accurately)
*
Address Zip Code
*
Office Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone
*
Format: (000) 000-0000.
Email Address
example@example.com
What materials do you have for pickup, and approximately how much?
*
Please describe your request, including material and approximate quantity. Examples: 25 catalytic converters, 100 rotors, 500lbs. of scrap metal, or 2 tons of aluminum
Do you have Catalytic Converters for pickup?
*
Please Select
Yes
No
Not Sure
# of Catalytic Converters?
📸 Photos of Material / Dumpster
Browse Files
Drag and drop files here
Choose a file
Please upload clear photos of the material, dumpster, or dumpster placement area. Photos help us determine the correct truck, equipment, and service priority.
Cancel
of
Call Ahead?
Please Select
Yes
No
Special Pickup / Dumpster Instructions (Optional)
Pickup scheduling is based on location, material type, quantity, truck availability, and route efficiency. Submitting this form is a service request and does not guarantee same-day or next-day pickup. Our team will review your request and contact you if additional information is needed.
⭐ Help Us Improve Your Experience! ⭐
We're always looking for ways to make doing business with Christensen Recycling easier, faster, and more convenient.
How easy was it to complete this pickup request form?
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How can we improve your experience with Christensen Recycling?
Submit Pickup Request
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