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LIBERTY COUNTY SOLID WASTE ENTERPRISE FUND LIBERTY COUNTY BOARD OF COMMISSIONERS Liberty Courthouse Annex 100 N Main St, Suite 1510 Hinesville, Georgia 31313 (912) 884-5353 APPLICATION FOR DUMPSTER SERVICE Applicants Name: Applicant’s Mailing Address: City/State/Zip Code: Daytime Phone Number: Business Name: Business Physical Location: Terms of solid waste refuse container service contract: 1. A non-interest bearing deposit equal to one months total billing will be paid before any container(s) is (are) delivered to the service location. 2. A fee of $75.00 is required for placing and removing the first container. Additional containers placed at the same service location will be placed and removed at a fee of $50.00 each. Such fees will be paid in advance of container delivery. 3. The applicant is required to provide and maintain a suitable hardstand and unobstructed pick-up site for each refuse container as pre-coordinated with the Liberty County Solid Waste Operations Manager. 4. service payments are due by the 20th of each month and shall be payable to the Liberty County Solid Waste Authority at the above address. 5. Payments received after the 20th of the month will be assessed a late fee equal to ten (10) percent of the outstanding balance as of the due date of the payment. 6. If service payments (including any late charges) are not received within 30 days of the due date, refuse service will be discontinued, all containers will be removed from the service location(s), the Health Department will be so advised, and the matter will be turned over to a debt service agency. Reestablishment of services will require negotiation of a new dumpster service contract. 7. Upon termination of refuse disposal services, the deposit will be applied to any unpaid balances (including applicable late charges) of the applicant and any amount remaining will be refunded within 30 days of termination. Service fees will be pro- rated for less than thirty (30) days provided 20 days advance written notice is given by the applicant to the above address. 8. Containers which have been vandalized or burned will be removed and replaced at the discretion of Liberty County. A placement/removal fee will be assessed for such services. 9. The applicant is responsible for insuring the proper placement of refuse in the container. Refuse placed outside the container remains the responsibility of the applicant. 10. The applicant is responsible for insuring the exclusion of any hazardous waste, medical waste, petroleum products (including used filters), or liquids in excess of one gallon from all refuse contents. Failure to comply with this term will result in immediate removal of all containers from the service location and notification of the Georgia Department of Natural Resources, Environmental Protection Division. 11. The service fees specified below are subject to revision as approved by the Liberty County Board of Commissioners. Applicant has read, understands, and agrees to the terms stated above and to the provisions of the Liberty County Code of Ordinances, specifically Chapter 15, Solid Waste. Applicant’s Signature Date Applicant’s Name (Type/Print) For Solid Waste Operations Manager Use Only: Service Location and Route Quantity & Capacity (CY) of container(s) Frequency of pick-up Fee TOTAL FEE Customer Account Number