Hazardous Waste & Paint Form

HOUSEHOLD PAINT & CHEMICAL COLLECTION

City of Alpharetta

WHEN: Saturday - November 16, 2024

PRE-REGISTRATION FORM

First Name

Last Name

Home Address

Please include address where you reside in Alpharetta

E-mail Address

All event communication will be via email

Phone Number

Preferred drop off time

8:30 a.m - 11:00 a.m.
11:00 a.m. - 1:00 p.m.

Please indicate below the types of materials you will bring and the approximate amount of each. Please use the units indicated below in parenthesis for your estimate.

Aerosol Paints (Spray Cans)

Include number of cans

Latex Paints - water based, in original cans

include number of gallons (Limit 10 Gallons)

Oil Based Paint, Stains and Varnishes in original containers

include number of gallons (Limit 10 Gallons)

Automotive or Flammable liquids like gasoline, kerosene, lighters, transmission or brake fluids, etc.

include number of gallons (Limit 10 Gallons)

Solvents, thinners, mineral spirits

Number of gallons

Pesticides, herbicides, lawn and garden chemicals (Solids)

pounds of solids

Pesticides, herbicides, lawn and garden chemicals (Liquid)

pounds of liquid

Fertilizer

pounds of liquid or solids

Pool and spa chemicals

pounds

Items with mercury

Number of items

Household Cleaning Products

Number of gallons

Please do not bring:

Truck and automotive batteries

Electronics

Fire Extinguishers

Propane tanks

Medical or prescription drugs

Call if you have questions (678) 297-6200

I hereby certify that the items listed above are derived from household use only and nothing delivered by the name above has been produced or used by a business. I also certify that I am a resident of the City of Alpharetta. *

Agree

Electronic Signature

Please type your full name below.

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