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Name
First
Last
Company
(Required)
Company Title
(Required)
Phone
(Required)
Email
(Required)
Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Type(s) of Material to be Baled (select all that apply):
Paper Trim
Waste Paper
Cardboard
Boxboard
Non-Wovens
Plastic Wrap
Plastic Bottles
Cotton
Wool
Fiberglass
Man-Made Fibers
Carpet Remnants
Foam Rubber
Tobacco
Films
Non-Ferrous Metals
Used Clothing
Other
Condition of Material:
Whole
Trim
Shredded
Chopped
Other
Physical Dimensions of the Material (size of largest piece):
Method of Feeding Baler (select all that apply):
Conveyor
Cart Dumper
Air System
Manually by Hand
Other
Estimated Volume of Material to be Baled (in pounds, tons or cubic feet; per hour, day or month).
Number of Work Hours Per Day/Week:
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