Fillable Application For Construction And Demolition Roll-Off

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Application For Construction And Demolition Roll-Off

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CITY OF HELENA C & D ROLL-OFF ACCOUNT
Phone: 406-447-8082 Fax: 406 447-8083
Email: Solidwaste@helenamt.gov
ROLL-OFF ACCOUNT APPLICATION
START DATE: _________________
ACCOUNT #:____________________
BUSINESS NAME: ___________________________________ RAMSPRO #: ___________________
USER #:
CONTACT NAME: ________________________________________
CONTACT PHONE #_______________________________________
BILLING CONTACT INFORMATION: SERVICE LOCATION:
NAME: _____________________________ ____________________________________
ADDRESS: _____________________________ ____________________________________
_____________________________
IF BILLING ADDRESS IS P.O. BOX – A PHYSICAL ADDRESS IS REQUIRED: ___________________________
TELEPHONE: ___________________________ ___________________________
E MAIL: _____________________________ ___________________________
CONTAINER SIZE: 20 YD 30 YD 40 YD
PLACEMENT INSTRUCTIONS: _____________________________________________________________
_______________________________________________________________________________________
________________________________________________________________________________________
__________________________________________ ___________________________
BILLING CONTACT SIGNATURE DATE
DO NOT OVERFILL CONTAINER
C&D waste must not extend above the sides of the container.
Overfilled containers will not be serviced until material is properly arranged.
A 5-ton allowance included per container; overages will be billed @ current C&D rate
Container contents cannot exceed 20000 Pounds
30 day rental included – Monthly Rental Charge available to extend Container Rental
Billing Cycle Begins each time Container is Serviced
IF
APPLICABLE
CITY OF HELENA TRANSFER STATION
PRE-ACCEPTANCE AGREEMENT FOR C & D ROLL-OFF ACCOUNTS
The City of Helena Solid Waste Division reserves the right to inspect any load or portion serviced by our facility.
We will reject all prohibited wastes and any unacceptable waste as determined by our management. The
following materials
will not be accepted
in C&D Roll-off containers serviced by the City of Helena Solid Waste:
HAZARDOUS WASTE
PCB WASTE
LIQUIDS
MEDICAL WASTES
ASBESTOS
BULK OR LOOSE VERMICULITE
BULK OR LOOSE INSULATION
LARGE CONCRETE
EXPLOSIVE TANKS (i.e. propane tanks, gas, waste oil, etc.)
TIRES
FREON UNITS
HOUSEHOLD GARBAGE
ONLY CONSTRUCTION & DEMOLITION WASTE IS ACCEPTED
THERE WILL BE A SITE INSPECTION BY A SOLID WASTE SUPERVISOR TO ENSURE THAT MATERIALON SITE IS
C & D WASTE - ACCEPTABLE CONSTRUCTION & DEMOLITION MATERIAL LIST IS ATTACHED
If you rent a Roll-off container and are discovered to be disposing of prohibited materials, your actions will be
reported to the regulatory agency of the State of Montana Solid Waste Program. In addition, you will be required
to pay for all costs associated with the clean-up, transport and disposal of prohibited wastes at both the City of
Helena Transfer Station and the Lewis & Clark County Landfill to a facility of our choice. You may also lose future
Transfer Station disposal privileges.
Waste Generator/Customer agrees and warrants that he/she is disposing only non-regulated solid waste in the City
of Helena Roll-off Containers and does hereby indemnify the facility/operator for damages caused by delivery of any
hazardous, toxic or otherwise unacceptable material..
NOTICE
•
Any damage to container while in customer’s possession shall be the responsibility of the customer.
•
Any damage to tarp due to overloading of the container shall be the responsibility of the customer.
•
Container contents cannot exceed 20000 Pounds
Customer will be responsible for repair costs and materials to Container or Tarp if damaged. In the event the
container is damaged beyond repair customer will cover cost of container replacement to include freight charges.
By signing below – you agree to the above terms & conditions.
Waste Generator/Customer Signature Date
July 1
st
, 2018
Update for C&D Customer Roll-off Rental
Please note: The City of Helena Solid Waste has implemented violation fees for household rubbish that
is found in C&D Roll-off Rentals. Any Roll-offs found to have any other rubbish than the acceptable
items listed below will be subject to additional fees.
The f
ees are:
Violation $75.00 Violation Fine
Tonnage Charge $50/ton Based on 5 tons
C&
D Roll-off Package is $240.45 for up to 5 tons/ additional tonnage is billed at $23 per ton
C&D Roll-off with Violation will be a minimum of $450.45 up to 5 tons/additional tonnage is billed at
$50 per ton.
Thank you for your cooperation.
Acknowledgement Signature
Company Date
Adhesive Containers (Dry)
Insulation – Foam, treated Cellulose
Pressboard
Aluminum
Insulation – Sheathing
Pressure Treated Wood
Sheathing
Iron
Roofing Material - Felt
Asphalt (paving & shingles)
Laminate
Sealants
Brick
Leather
Sealer Tubes (Dry)
Cabinets
Linoleum
Sheet metal
Carpeting
Lumber
Siding – Aluminum
Carpet Padding
Masonite/Slate
Siding- Vinyl
Caulking Tubes (Dry)
Masonry
Siding- Wood
Ceiling Tiles
Metal-small
Silicon Containers (Dry)
Cinder Blocks
Milllends
Solvent Containers
Concrete w/Rebar
Mortar
Stone/Rocks
Corrugated Shipping Containers
Nails
Strand board
Dirt/Earth (clean)
Paper Products
Styrofoam
Electric Fixtures
Packaging Foam
Textiles
Electrical Wiring
Pallets/spools
Tile- Ceiling & ceramics
Fiberboard
Paperboard
Treated Wood
Fiberglass
Particleboard
Stumps
Fireproofing products (Overspray)
Plaster
Painted wood
Flashing
Plastic buckets
Untreated wood
Flooring Tiles
Plastic Sheet Film
Veneer
Furniture – including Mattresses
Plastic– PVC pipe
Vinyl Doors
Glass
Plumbing Fixtures
Vinyl Flooring
Gypsum Wallboard
Plywood
Vinyl Windows
Insulation – Fiberglass
Polyethylene
Wood composites
Wire
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Application For Construction And Demolition Roll-Off

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Completed 12 July 2020

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