Special Event Recycling Container Application & Agreement

Prince William County
Solid Waste Division
5 County Complex Court, Suite 250
Prince William, Virginia 22192
p: (703) 792-4670 / f: (703)792-461

1. Instructions: Please complete this loan agreement and submit it to the Division at least one week prior to your event. At the end of the event, please complete the attached Post Event Information Report. If you have any questions, please contact the Division at (703) 792-4670.

Today's Date:

Event Date(s):

2. Name of Event:

3. Contact:

4. Title:

5. Organization:

6. Address (Street/City/State/Zip):

7. Phone:

8. Fax:

9. Email:

10. Brief Description of Event:

11. Est. # Attendees:

12. Est. # Food Vendors:

13. # Bins Requested:

14. What type of beverage containers will be distributed at this event?

15. How/where will materials be recycled after the event?

16. Please indicate company: *This question is required.

16. Solid Waste Staff Use:

Pick Up Date:

Return Date:

# Bins Requested:

# Bins Received:

# Bins Returned: