Fixed Load.

Name

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Email(*)

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Phone(*)

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Address or Postcode(*)

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Collection Date(*)

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Type of Rubbish

Collection Pickup Area

Driveway / front garden

Rear garden

Garage

Inside building

Access via alleyway (please specify walking distance)

Other - please specify in comment box

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Parking Available

Yes

No

Restrictions in force - Please state in comments box below

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