READ THEN FILL OUT FIELDS BELOW TO PROCESS FORM!

All solid waste customer locations with an active utility account are eligible for one free special pickup per calendar year.  Please note: this program replaces the annual Clean Up-Fix Up Week.  Free special pickups are ONLY completed on Monday, Tuesday, or Thursday, EXCLUDING weeks that include a City-observed holiday where city offices are closed for business.  Observed holidays are shown on City Calendar.  Available days in a week may also be limited due to inclement weather or unforeseen circumstances. 

The free pickup is subject to limitations set by the City of Jackson Sanitation Department's rules and regulations.  Eligible items must be placed on the ground by the street so it is clear that it is intended for pickup by City personnel.  Please review the Special Pickup Rules to be sure any item is eligible for this program.   Wet paint can't be accepted, even if can is sealed tightly.  Please see rules for more info.  Although you can contact us as late as 3 PM on the day prior to the desired pickup date, due to the popularity of the program, we encourage you to make a request at least two weeks prior to the requested date.

For more information prior to submitting a request, please contact Public Works at pickup@jacksonmo.org or 573-243-2300. 

To request a specific day for your free special pickup, please complete the form below and click on Submit button.  City staff will contact you to confirm your requested day or set up an alternate day, if your requested day is unavailable.

**************************************************************************** 

Utility Account Number (if known): 

Last Name: 

First Name:  

Phone Number:  

Email Address or Other Contact Method 

YOUR EMAIL ADDRESS IS USED ONLY TO CONFIRM PICKUP DATE AND CLARIFY ANY INFO FOR THE SPECIAL PICKUP.  DUE TO DEPARTMENTAL WORKLOAD, RESPONSES TO EMAILS MAY BE HANDLED FASTER THAN PHONE RESPONSES (enter "Phone only" if no email address):

Location's Address

Street Address: 

Unit (if applicable):  

REMEMBER TO REQUEST A MONDAY, TUESDAY, OR THURSDAY DURING A FULL WORK WEEK!  DON'T PUT OUT ANY ITEMS TO BE PICKED UP UNTIL YOU RECEIVE CONFIRMATION FROM THE CITY.

AS OF 10/25/21, 4 PM, THE FIRST AVAILABLE  FREE PICKUP APPOINTMENT DAY IS THURSDAY, 10/28/2021. 

DATES REQUESTED for Special Pickup (request first, second, and third choice - each date must be a Mon., Tue., or Thur.):  

First Choice (MM/DD):  

Second Choice (MM/DD):  

Third Choice (MM/DD):  

Notes: