2. 
6. REQUEST FOR HOUSEHOLD HAZARDOUS WASTE AND E-WASTE PORCH PICKUP
   Please fill in the information as described below and click "SUBMIT" to complete your request.
8. City of Haslet Water Bill Account Number*
   Required--enter your water bill account number with no dashes or spaces
10. First Name*
11. Last Name*
13. STREET ADDRESS*
15. Preferred Telephone Number*
17. Email Address for Primary Contact*
21. Provide specific description(s) of items to be picked up*
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23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

* indicates a required field