Family Owned & Operated Since 1995! | Serving the Chicagoland Area & Northwest Indiana

Scale Account Authorization Form

Tri-State Disposal

Scale Account Authorization Form

Tri-State Disposal Logo

General Information

Type(Required)
Types Of Materials You Will Be Disposing Of(Required)
Select all that apply to what you will bring in to dump.

Account Set Up

Billing Address

Authorized Vehicles

Please provide a list of vehicles who are approved to dump under this account. You are responsible for notifying Tri-State Disposal of any changes to these authorizations.
Vehicles
License Plate
Vehicle Make, Model, Color
 

Authorization & Payment

Credit Card Details(Required)
How would you like to submit your credit card information?
By entering your name, you authorize Tri-State Disposal to process payments on the credit card provided for all dumps brought into this facility.

Need assistance? Contact Us Today!

Submit your request or issue right now, entirely online.