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2. Request Date
4. Type of Dumpster (size)
6. Place to be set
8. Set date
9. Pick up date
11. Name
12. Phone Number
14. Email address
16. Reminder!
    Dumpsters will not be set until rental for said dumpster is paid.
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18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit Submit and Print

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