North Lincoln Sanitary

Name:				Phone:
Billing Address:				Email:
Service Addres:				Account Number:
Check if Billing Address is Same as Service Address.
I don't have an account with North Lincoln Sanitary.

Order New Service

Vessel Sizes		96 Gallon		64 Gallon	32 Gallon


Vessel Location		Roadside Service		Carry Out Service

Frequency	Once Per Week		Every Other Week		Once Per Month

Transfer Service to New Address	New Serivce Address

	Start Date - 1st pick-up date


Cancel Service		Old Service Address

		Cancellation Date - last pick-up date

I'm interested in EasyPay*		*EasyPay is our online automatic payment option. With EasyPay, you can eliminate the hassle of writing checks and buying stamps.

Security Deposit For This Order* *This amount is an estimate. The actual amount of your security deposit may be higher or lower. We will be in contact with you for payment.

A copy of this request will be sent to the provided email address.

Name:				Phone:
Billing Address:				Email:
Service Addres:				Account Number:
Check if Billing Address is Same as Service Address.
I don't have an account with North Lincoln Sanitary.

Order New Service

Vessel Type		96 Gallon		Cardboard Container


Vessel Location		Roadside Service		Carry Out Service

Frequency	Once Per Week		Every Other Week		Once Per Month

Transfer Service to New Address	New Address

	Start Date - 1st Pick-up Date

		Items(s) Description

Cancel Service		Service Address

		Cancellation Date - Last Pick-up Date

I'm interested in EasyPay*		*EasyPay is our online automatic payment option. With EasyPay, you can eliminate the hassle of writing checks and buying stamps.

Security Deposit For This Order* *This amount is an estimate. The actual amount of your security deposit may be higher or lower. We will be in contact with you for payment.

A copy of this request will be sent to the provided email address.

Name:				Phone:
Billing Address:				Email:
Service Addres:				Account Number:
Check if Billing Address is Same as Service Address.
I don't have an account with North Lincoln Sanitary.

Order New Service

Vessel Types		10 Yard		20 Yard
		30 Yard		40 Yard
			Dump Trailer



Drop Off	Date

Pickup	Date

	I will call for pickup (541-994-5555).

Security Deposit For This Order* *This amount is an estimate. The actual amount of your security deposit may be higher or lower. We will be in contact with you for payment.

A copy of this request will be sent to the provided email address.

Name:				Phone:
Billing Address:				Email:
Service Addres:				Account Number:
Check if Billing Address is Same as Service Address.
I don't have an account with North Lincoln Sanitary.

Order New Service

Pickup Date:

Description:

A copy of this request will be sent to the provided email address.

Name:				Phone:
Billing Address:				Email:
Service Addres:				Account Number:
Check if Billing Address is Same as Service Address.
I don't have an account with North Lincoln Sanitary.

Order New Service

Purchase Containers			1 Gallon:

			35 Gallon:

Schedule Pickup			Pickup Date:

			Description:

A copy of this request will be sent to the provided email address.

Name:				Phone:
Billing Address:				Email:
Service Addres:				Account Number:
Check if Billing Address is Same as Service Address.
I don't have an account with North Lincoln Sanitary.

Order New Service

Drop Off Date

Pickup Date

		I will call for pickup (541-994-5555).

A copy of this request will be sent to the provided email address.

Name:				Phone:
Billing Address:				Email:
Service Addres:				Account Number:
Check if Billing Address is Same as Service Address.
I don't have an account with North Lincoln Sanitary.

Order New Service

A copy of this request will be sent to the provided email address.

Dear Drop Box Customer,

Please review and confirm by your signature below that you have read and understand the requirements and restrictions for drop box use.

NLSS offers the following Drop Box Sizes in cubic yards: 10, 20, 30, and 40.
The Drop Box needs to be emptied at least once every 7 days. On the 8th day a $20/day demurrage will be added. The boxes can be used for disposal of bulky materials, light demolition, tree trimming, or other general cleanup projects.

If you are disposing of dirt, rock, sod, concrete or any other heavy dense material, a 10 cubic yard drop box is the only size we can allow.
If you are disposing of composite (3 tab, asphalt shingle) roofing material, then a 20 cubic yard drop box is the largest size we can allow.

Unacceptable items in any drop box include but may not be limited to the following:

E-waste (TVs, computers, and computer monitors)
Liquids that will pass through a paint filter
hazardous materials (i.e. liquid paint, liquid pesticides, liquid chemicals, asbestos, vehicle batteries)
infectious waste, medical waste, or radioactive waste as defined by applicable by state, federal, or local laws or regulations
The following items banned from Landfills may be placed in a drop box, but NLSS needs to be informed:
- Large Appliances (refrigerators, stoves, heaters) - Place at front of box.
- Tires - Place at back of box.

Overweight or overfilled boxes can be subject to additional fees and may require removal of materials by the customer before the box can be hauled.

As a drop box customer you will be responsible for all fees incurred including delivery, haul, disposal and may include additional fees such as: rent, damage to box, testing, clean up, abatement of unacceptable items, etc....

All Construction and Demolition debris must be accompanied with documentation proving the load does not contain asbestos-containing material - a Construction and Demolition Waste Acceptance Form. If any material in the box could be considered suspect for Asbestos-Containing Material (ACM), including but not limited to flooring, sheetrock, duct work, roofing material, plaster, popcorn ceiling, or anything else that looks like it came from a remodel or demolition, the hauler and/or disposal site may refuse the box until the customer can provide documentation proving the load does not contain ACM. If a box is picked up and undeclared, suspect, ACM is discovered at the transfer station, the customer will be charged for all cleanup costs.
Cleanup could range in the thousands of dollars.

I am disposing of construction, demolition, or renovation material.

Construction and Demolition Waste Acceptance

To protect the health and safety of our employees and customers, all loads of construction, remodeling and demolition waste brought to Schooner Creek Public Transfer Station (SCT) are screened before, during, and after unloading for materials that may contains asbestos. This form is required for all such loads of waste that contain construction or demolition waste.

Analytical test results are required for the following products commonly known to contain asbestos:

Interior walls and ceilings: acoustical tiles, glue dots, plaster, and textured surfaces.
Exterior walls: cement siding, stucco.
Flooring: vinyl tiles, sheet vinyl, some mastic adhesives
Insulation/fireproofing: block, boiler, spray-applied, vermiculite, monokote, sink undercoating, thermal system insulation (fiberglass, cellulose, and mineral wool are exempt).
Gaskets: furnace, mechanical, boiler, wood stove (automotive gaskets are exempt).
Heating: white paper or seam tape on ducts, air duct cement and insulation.
Roofing Materials: tar paper, felt, silver/white roofing paint, Nicolite paper (Note: three tab composition shingles do not contain asbestos).
Fire doors, Fire/kiln brick and fireproofing
Various Compounds: window glazing, adhesives, caulks, patching, mastics, vapor barrier products (plastic or sythetic materials such as Tyvek are exempt).
Electrical: switch gear, circuit boxes and fuse panels; wiring with cloth insulation (Romex wiring is Exempt).

Please Note: Flat/built-up roofing, typically with layers of roofing (built-up) that has a mopped on asphaltic material on top of the petroleum-based felt-type/rolled roofing material, has to have test results showing it has no asbestos in it, regardless of when it was constructed.

Instructions for Filling out this Form:

This form is required for all loads containing construction, demolition, or renovation material.
This form should be completed by the person responsible for and knowledgable about the contents of the load.
For multiple loads, only one form needs to be filled out, but the contents of the load must match the description of the waste materials on the form.

All parties involved (generator, contractor, and hauler) may be held responsible for the abatement of positive (greater than one percent asbestos by weight) asbestos-containing materials unloaded at SCT's transfer stations, including but not limited to the costs for testing, a licensed abatement contractor, fines, and administration.

When did the construction, demolition, or renovation materials originate from the structure or RV?

Was the material constructed after Jan 1, 2004?

Is the material bare wood, glass, or three tab compostion shingles with no tar paper?

Was the material constructed before Jan 1, 2004?

If billing to an NLSS account, enter the name on the account or the account number if known:

Drop Box Use & Material to be Disposed:

Drop Box Location (address):

Mailing Address (if different):

Email Address:

Phone Number:

By adding my name to this form, I warrant that the information provided is truthful and accurate to the best of my knowledge and agree that this shall act as an electronic signature in place of a hand-written signature. If you would like to fill out a pdf version of this form instead, click here.

Enter Full Name as Signature:

Click the image below for a printable PDF.