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2. Snohomish County Solid Waste Division Credit Account Request Form
   New customers that wish to open a credit account must complete a Credit Account Request Form. Please provide the following information:
4. First Name*
5. Last Name*
7. Business Name*
8. Phone Number*
10. Email*
14. 1) What is your business type? Please indicate all that apply.*

    1. Construction
    2. Demolition
    3. Landscaping
    4. Recycling

    1. Roofing
    2. Vactor Waste
    3. Other
16. 2) What service(s) are you inquiring about? Please indicate all that apply.*

    1. Environmental Cleanup
    2. Waste Disposal

    1. Vactor Waste
    2. Other
18. 3) How often do you anticipate posting charges to your credit account per month?*

    1. Less than 10 times
    2. 11-20 times
    3. Over 21 times
20. 4) What is the average net weight of a disposal load?*

    1. Less than 1 ton
    2. 2-3 tons
    3. More than 3 tons
22. 5) What is your Unified Business Identification (UBI) number?*
24. 6) Do you have any special circumstances to be considered?
28. Contact Information
    Please specify your contact information.
30. Governing Person
32. First Name*
33. Last Name*
35. Phone Number*
36. Email*
38. Accounts Payables
40. First Name*
41. Last Name*
43. Phone Number*
44. Email*
46. Operations
48. First Name*
49. Last Name*
51. Phone Number*
52. Email*
56. Vactor Decant Waste Facility Customers

    **This section is for customers that wish to use the Vactor Waste Decant Facility ONLY.  If you do not wish to use the Vactor Waste Decant Facility, you DO NOT have to complete this section.

    
    

    The Snohomish County Vactor Waste Decant Facility is a self-service station that processes, treats, and disposes stormwater materials. Service fee for Vactor waste is $315.00 per truck load. Acceptable waste includes:

    • Stormwater drainage system solids and liquids
    • Decant liquids

    Please complete this portion of the form if you wish to gain access to the facility. To expedite the approval process, be sure to include your chemical analytics with this form.

58. Origin of Material

    1. Catch Basins
    2. Stormwater Detention/Treatment Structure
    3. Stormwater Conveyance Structure

    1. Private Business
    2. Outside Snohomish County
    3. Other (Specify)____________________
60. Type of Material

    1. Stormwater drainage solids and liquids
    2. Decant liquids only

    1. Stromwater treatment media (filters)
    2. High volume load
62. Additional Information
64. Attach Chemical Analytics
Leave This Blank:


68. 1. Receive an email copy of this form.
69. Email address

    This field is not part of the form submission.

70. Submit Submit and Print

* indicates a required field