Please allow up to two business days to complete this online request and a customer service representative will contact you to schedule the repair. Requests are processed Monday through Thursday.

1

Date of Application

 *

Date of Application

2

Account Number (located on your water bill, click here to log into your utility account)

Account Number (located on your water bill, click here to log into your utility account)

3

Name

 *

Name

4

Address

 *

Address

5

Phone Number

 *

Phone Number

6

Email Address

 *

Email Address

7

Damaged Trash Cart (Brown)

Damaged Trash Cart (Brown) (Select an Answer) Lid Wheels Body

8

Damaged Recycling Cart (Blue)

Damaged Recycling Cart (Blue) (Select an Answer) Lid Wheels Body

9

Damaged Manure Waste Cart

Damaged Manure Waste Cart (Select an Answer) Lid Wheels Body

10

Brief Description of damage

 *

Brief Description of damage

11

Please email Trash.Recycling@QueenCreekAZ.gov with any questions.

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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