Submit by Email
3237 US Hwy 19, Cochranton, PA 16314
ph. 814-425-7773
fax. 814-425-3201 email: [email protected]
From household waste to electronics, ECS&R handles it. Complete this simple Collection Guide and ECS&R will provide a cost effective option for disposal.
Name
Phone Number
Street
City
State
Zip Code
Quantity
Electronics Inventory/Items
Desktop computers
Laptop computers
Desk printer, scanner, fax, copier
Flat screen monitor up to 17"
Flat screen monitor larger than 17"
CRT/Tube monitor up to 17"
CRT/Tube monitor larger than 17"
Accessories (mouse, speakers, Keyboard, drives, ect)
Stereo CD, DVD, Blue Ray, VCR, Tape Player, ect.
CDs, DVDs, Blue Ray Discs, Cassette/A-Track Tapes
Cell phone/Telephone
Flat screen LCD/LED TV up to 42"
Flat screen LCD/LED TV larger than 42"
CRT/Tube Television up to 27"
CRT/Tube Television larger than 27"
Console Television
Microwave Oven
Dehumidifier
Room air conditioner
Small Refrigerator
Other
Specify
Chemical Inventory/Items
Size
Size
Size
Size
Size
17"
19"
21"
26"
32"
37"
42"
42"
46"
48"
50"
52"
55"
60"
12"
14"
19"
21"
24"
27"
30"
32"
36"
50"
Size
Size
Size
Size
Size
Size
QTY
Size
QTY
Type
QTY
Size
QTY
Size
QTY
Type
Bleach, household cleaning products (bases)
Acid household cleaning products (bowl cleaner)
Aerosols
Pool/Spa chemicals
Wood/metal cleaners and polishes
Pesticides, herbicides, fungicides
Oil
Antifreeze
Gas, diesel, kerosene and additives
Car wax and polish
Paint, stain, thinner and finishes
Adhesives and glue
Other
Specify
MISC Items
QTY
Common batteries (alkaline, zinc-carbon)
Lantern batteries
Button cells, reactive, mercury batteries
Incandescent, compacts, fluorescent bulbs
Spot lamps
Straight, U-shape
HID, Sodium and mercury vapor lamps
Neon, UV lamps
Mercury containing devices, per pound
Propane tanks (each)
TOTAL
*Price based on information given plus service fee
SIGNATURE
Type