Customer Stop Service Request

City of San Ramon Customers Stop Service Request

* = Required Information

THE CITY OF SAN RAMON, IN COMPLIANCE WITH THE STATE OF CALIFORNIA AND CONTRA COSTA COUNTY, REQUIRES ALL RESIDENTS TO SUBSCRIBE TO INTEGRATED WASTE MANAGEMENT COLLECTION SERVICES TO ENSURE ENVIRONMENTAL COMPLIANCE AND PROTECT PUBLIC HEALTH.

If you are unable to complete or submit this form, please call us at 925-380-9480.

Property owners who find themselves with an empty residential/commercial dwelling space where no utilities are consumed have an opportunity to temporarily stop services until another tenant establishes occupancy. A stop service form, IN ADDITION TO A VACANCY FORM WITH THE REQUIRED ATTACHMENTS, must be completed and submitted by the property owner. *

I acknowledge the above statement (please check box to continue).

Which service are you requesting to stop?: *

Single Family residential stop service
Multi-Family (5 or more units) residential stop service
Commercial stop service

Stop service date (ACI of San Ramon will stop service on your service date only and requires that your stop service request be submitted at least one business day before desired stop date): *

Customer Name: *

First

Last

Site Address: *

Address Line 1

City

State

Zip Code

Forwarding Address: *

Address Line 1

City

State

Zip Code

Please supply at least one phone number: (work)

Please supply at least one phone number: (home)

Please supply at least one phone number: (cell)

Email: *

Please have your carts at the curb by 5:30 a.m. on the day you are requesting we stop service. Your carts will be serviced as normal on your last service day and a second truck will remove the carts later that day. Billing will continue until ALL carts are removed.

I acknowledge the above statement (please check box to continue).

If available, please provide serial numbers of carts you have. Numbers are located on the front of the carts (example: G35 000012):

Garbage cart serial #:

Recyclables cart serial #:

Organics cart serial #:

If available, please provide serial numbers of bins you have. Numbers are located on the front top left corner of the bins (example:30003):

Garbage bin serial #:

Recyclables bin serial #:

Organics bin serial #:

If you paid a deposit when you started service, the deposit will be applied to your final bill. If you have a credit on your account a refund check will be mailed within one quarter after date service is stopped. *

I acknowledge the above statement (please check box to continue).

Signature: *

Clear Signature

Submission of this form must include a signature.

Additional comment / questions:

Phone