City of Temple Terrace Customer Service

3. Temporary Roll-Off Container Application
5. Customer/Contact First Name *
6. Customer/Contact Last Name *
8. Location for Roll Off*
10. Business*

    1. Yes
    2. No
11. Business Name
13. Billing Address*
15. City*
16. State*
17. Zip*
19. Contact Person's First Name *
20. Contact Person's Last Name
22. Contact Phone Number*
23. Business Phone Number
25. Today's Date*
26. Requested Service Date *
28. Deposit

    1. 20 YD $250.00 (8 feet wide, 22 feet long, 4 feet high)
    2. 30 YD $300.00 (8 feet wide, 22 feet long, 6 feet high)

    An Inactivity Fee of $100 will be assessed on all rentals that are not serviced within 30 days of rental. An additional $25 per week will be assessed for each subsequent week of inactivity.
30. BILLING RATE INFORMATION
32. All Units: $50 – Delivery/Set-up Fee. Also for relocates, and delivery refusals and/or unable to deliver or service.

34. 20 Yd. Construction Roll-off Pull Charge Rates: $193.80

35. 30 YD. Construction Roll-off Pull Charge Rates: $208.12

37. Disposal Fees*: Construction & Demolition Materials=$41.10/Ton Construction & Demolition Class III Materials=$44.00/Ton Non-processable Materials=$53.70/Ton Processable Materials (trash, food, etc.)=$70.77/Ton

39. Construction & Demolition Debris includes: Lumber, drywall, bricks & block, roofing material, etc. : **Note – concrete disposal is FREE of CHARGE (Pull Charge still applies!)
41. Construction & Demolition Class III Materials: This is Non-Processable and/or Construction & Demolition debris that is not recyclable.
43. Non-Processable “Class III” Debris: This debris may include any of the following: Furniture, mattresses, carpeting, plastic buckets, plastic sheets, & paint cans (empty) Pallets, packing materials, Styrofoam, cardboard, and paper (not food stained) Metals, aluminum cans, soda bottles, and White Goods (certified that Freon has been removed) Construction and Demolition debris.
45. NOTE: please allow at least 24 hours for any requested roll-off services to be completed. *Environmental fees and fuel surcharge fees apply and fluctuate according to market conditions.
47. Customer Signature *
49. Office Use Only
    Customer ID and Location, Accepted by
Leave This Blank:


50. Print Only

* indicates a required field