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2. Please complete the form below to request a Garbage or Green Cart exchange or to purchase an additional Green Cart. City staff will contact you within 2 business days to confirm your request, and arrange payment (if applicable). Please note, cart exchanges are typically scheduled the day after your next collection day to ensure the cart is empty.

4. Full Name*
6. Coquitlam Address*
8. Contact Information
10. Email*
12. Phone Number
14. Are you the home owner? *

    1. Yes
    2. No
18. Green Cart

    1. Upsize Green Cart
    2. Downsize Green Cart
    3. Purchase an extra Green Cart
20. Your Current Green Cart Size
    -- Select One --120 L240 L360 L
22. Upsize Green Cart To
    -- Select One --240 L360 L
24. Downsize Green Cart Size
    -- Select One --120 L240 L
26. Purchase An Extra Green Cart Size
    -- Select One --120 L240 L360 L
30. Garbage Cart

    1. Upsize Garbage Cart
    2. Downsize Garbage Cart

    Single-family homes are only permitted to have one Garbage Cart at their property, even if they have a legal secondary suite.

32. Your Current Garbage Cart Size
    -- Select One --120 litre240 litre360 litre
34. Upsize Garbage Cart To
    -- Select One --240 litre360 litre
36. Downsize Garbage Cart To
    -- Select One --120 L240 L
40. Green Cart Identification Number

    Located in white on the front of the cart.

42. Garbage Cart Identification Number

    Located in white on the front of the cart.

46. Freedom of Information and Protection of Privacy Act

    I understand by submitting this form I am consenting to the collection, use, and disclosure of my personal information for the purposes of Cart Maintenance Program in accordance with the Freedom of Information and Protection of Privacy Act, (the “Act”). That my personal information will be disclosed to a third-party service provider (i.e. Civic Plus and Smithrite) located in Canada for the purpose of processing my application. That if I have questions about the collection of my information I can contact the Solid Waste Programs Specialist at 604-927-3500 or email Waste Reduction.

Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit

* indicates a required field