Service Changes
Account # Date Name
Phone # Service Address
Type of Change (please click one option below):
Name Change to
Change of mailing address to
Additional 90-gallon black (trash) container*
Additional 90-gallon grey (green waste) container*
Discontinue garbage until further notice - vacation/house vacant
Exchange 60-gallon container for a 90 gallon*
Exchange 90-gallon container for a 60 gallon*
Other - Please Specify
Type Name Here:
By typing your name you agree to the following:
By typing in your legal name, you are signing this form electronically. You agree your electronic signature is the legal equivalent of your manual signature on this form. By typing in your legal name you consent to be legally bound by this form's terms and conditions. You further agree that your use of a keypad, mouse or other device to select an item, button, icon or similar act/action, or to otherwise provide the City of Escalon, or in accessing or making any transaction regarding any agreement, acknowledgement, consent terms, disclosures or conditions constitutes your signature (hereafter referred to as "E-Signature"), acceptance and agreement as if actually signed by you in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting contract between you and the City of Escalon. You also represent that you are authorized to sign this form for all persons who own or are authorized to access any of your accounts and that such persons will be bound by the terms of this form.
*If you add additional cans or swap to a different sized can, you must keep those cans for a minimum of 6 months before removing or swapping back.
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