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2. PLEASE NOTE
   Prior to submitting this form please first attempt to contact Waste Connections directly to report a missed pick-up by phone at 636-321-2100 or by email at wcmissouri@wasteconnections.com.
4. First Name
5. Last Name
7. Address1
9. Address2
11. City
12. State
13. Zip
15. Email
16. Phone Number
    Please provide a phone number where you can most easily be reached.
20. Regularly Scheduled Pick-Up Time*
    Regularly Scheduled Pick-Up Time

    Regularly Scheduled Pick-Up Time
    Please provide the date and time your trash would have normally been picked-up.
21. Other Information
    Please provide any other applicable information.
23. Service Missed*

    Please select the type(s) of residential waste that was missed.

    1. Trash
    2. Recycling
    3. Yard Waste
    4. Bulk Pickup
Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field