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1
Type & Size
2
Delivery
3
Your Info
4
Instructions & Agreements
Container Type & Size
Container Type
*
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Roll-off Dumpsters
Compactor
Storage Container
Dumpster Size
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10 Yard - 8'W x 12'L x 2'10"H
15 Yard - 8'W x 12'L x 4'3"H
20 Yard - 8'W x 22'L x 3'1"H
30 Yard - 8'W x 22'L x 4'8"H
40 Yard - 8'W x 22'L x 6'2"H
Date Needed
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What day do you need it delivered?
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Where is it going?
Delivery Address
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Address Line 1
Address Line 2
City
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Alabama
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Connecticut
Delaware
District of Columbia
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South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
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Your Info
Name
*
First
Last
Email
*
Phone Number
*
Is this for a company or homeowner?
*
Company
Homeowner
Company Info
Company Name
Company Phone
Company Address
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
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Any Special Instructions or Requests?
Customer Agreement
*
I understand and accept these guidelines
As an MDEQ Certified Class 1 Rubbish Site (Construction and Demolition Debris Landfill), we can accept a wide variety of waste and debris, including Construction & Demolition Debris, Brick Mortar, Concrete, Stone, Asphalt, Cardboard Boxes, Natural Vegetation (i.e. tree limbs, stumps, and leaves), Appliances, Plastic, Glass Crockery, Metal, Wood Drywall/Sheetrock, Shingles, and Cut or Shredded Tires. If you have any of non-acceptable wastes (kinds of waste not listed here) in your container, additional charges will be applied. If you have any questions about whether or not certain materials are acceptable, please contact us.
Customer authorizes any of its employees it sends to Creditor(s) to deliver or pick-up equipment or
materials, for purchase, rental, or repair to sign rental or delivery receipts or repair orders for said
equipment or materials and agrees to be bound by all the terms of said documents. In the Customer
directs Creditor(s) to deliver any material and equipment and Customer does not have a representative present at the time of delivery, Customer authorizes Creditor(s) to leave the material and equipment at the designated place of delivery. Upon said delivery, Customer will be responsible for said material and equipment. Customer will be responsible for any rental equipment until it is returned to the custody of Creditor(s). The acceptance of and use of purchase order numbers by Creditor(s) is for the convenience of Customer only. Customer agrees to examine all delivery tickets and/or payment receipts upon receipt. Unless Customer gives written notice by certified mail, return receipt requested, within three (3) days of delivery, Customer waives any claim the customer may have for any determinable deficiency or defect in said delivery, product, or repair and any objection to the amount of the payment receipt. This Credit Card Authorization Form supersedes any inconsistent provision in any purchase order. Absence of a purchase order number shall not constitute grounds for nonpayment or dispute of charges when Customer has had possession, or the right to possession of the items charged.
Customer shall indemnify and hold Creditor(s) harmless against any and all claims, demands, liabilities, losses, damages and injuries, whatsoever kind or nature, and all attorney’s fees, costs and expenses relating to or in any way arising out of the ordering, acquisition, delivery, installation, possession,
maintenance, use, operation, control, loss, damage, destruction, return, surrender, sale or other
disposition of the material and equipment purchased or rented. This indemnity shall not be affected by
any termination of this Agreement with respect to said materials and equipment.
The parties agree that this is the entire agreement, and that no oral representation or agreement has
been made which would modify this Agreement or be a condition precedent or subsequent to the
enforcement of this Agreement and that this Agreement may not be modified except by writing signed by both parties. The invalidity of any portion of this Agreement shall not affect the remaining valid
portions thereof. Failure to strictly enforce any provision of this Agreement shall not be construed as a waiver thereof and shall not excuse Customer from strict performance. The undersigned acknowledges that s/he has read and agrees to be bound to the terms of the Credit Card Authorization Form. The undersigned certifies s/he is authorized to enter into contracts for the company by the signature below. I authorize CWM, LLC and/or Pea Ridge Recycling, LLC to charge my credit card on file for agreed upon purchases.
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