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Broken, Lost or Stolen Roll Carts

2. 
3. Please fill out the following form.
   After receiving your request, Town Hall will contact Waste Industries via their portal application and submit a work order to have your cart(s) replaced. Please expect a new cart within several business days, unless submitting on Friday or before a holiday. The sooner the request is submitted the faster your cart will be replaced. If your request has not bee fulfilled within a full week please contact Town Hall at (910) 259-2151.
5. First Name*
6. Last Name*
8. Address*
10. Date
    Date
11. Which cart needs to be replaced?*
    -- Select One --Trash CartRecycle CartBoth

    Please pick one.
13. What happened to the cart?

    1. Lost

    1. Stolen

    1. Broken Lid

    1. Broken Side/Wheels
Leave This Blank:


15. 1. Receive an email copy of this form.
16. Email address

    This field is not part of the form submission.

17. Submit

* indicates a required field