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2. Please complete the form below to request a Garbage or Green Cart repair/replacement. City staff will contact you within 2 business days to confirm your request, schedule the repair/replacement date, and arrange payment (if applicable). Please note, cart repairs/replacements are typically scheduled the day after your next collection day to ensure carts are empty.

4. Full Name*
6. Coquitlam Address*
8. Contact Information
10. Email*
12. Phone Number
16. Cart Selection*

    Select the cart that is damaged and provide details on the type of damage.

    1. Garbage Cart
    2. Green Cart
18. Garbage Cart Identification Number

    Located in white on the front of the cart.

20. Garbage Cart Collection Day
    -- Select One --MondayTuesdayWednesdayThursday
21. AM or PM Zone
    -- Select One --AMPM
23. Garbage Cart Collection Location
    -- Select One --Front StreetRear LaneSide LaneOther
24. Specify Other
26. Cause of Damage
    -- Select One --BearAnimalCollection TruckTheftOther
27. Specify Other
29. Type of Damage

    Select all that apply.

    1. Lid Missing
    2. Lid Cracked
    3. Lid Bent
    4. Hinge Pins Missing
    5. Hinge Damaged
    6. Cart Body Cracked Open/Leaking
    7. Cart Body Bent/Dented
    8. Axle Detached from Cart Body

    1. Wheel Cracked
    2. Wheel Bent
    3. Tire off Rim
    4. Wheel off Axle
    5. Clips Do Not Close (missing springs)
    6. Clips Bent
    7. Clips Detached or Missing
    8. Other (please provide additional information below)
31. Specify Other
33. Did damage occur on collection day?

    1. Yes

    1. No
35. Upload a photo of your Garbage Carts damage.
37. Additional Information
41. Green Cart Identification Number

    Located in white on the front of the cart.

43. Green Cart Collection Day
    -- Select One --MondayTuesdayWednesdayThursday
44. AM or PM Zone
    -- Select One --AMPM
46. Green Cart Collection Location
    -- Select One --Front StreetRear LaneSide LaneOther
47. Specify Other
49. Cause of Damage
    -- Select One --BearAnimalCollection TruckTheftOther
50. Specify Other
52. Type of Damage

    1. Body
    2. Clip(s)
    3. Hinge

    1. Lid
    2. Wheels – Tire off Rim
    3. Wheels – Bent, still attached

    1. Wheels – Off axle/missing
    2. Other
53. Specify Other
55. Did damage occur on collection day?

    1. Yes

    1. No
57. Upload a photo of your Green Carts damage.
59. Additional Information
61. Please Note

    The clips on the Green Cart are wildlife-resistant, NOT wildlife-proof. It is resident's responsibility to make sure their Garbage and Green Carts are not accessed by wildlife outside of collection day. If your carts sustain damage from wildlife due to improper storage, you may be charged for cart repairs/replacements. Under the Wildlife and Vector Control Bylaw (PDF), residents can be fined up to $500 for not properly securing waste.

63. Freedom of Information and Protection of Privacy Act

    I understand by submitting this form I am consenting to the collection, use, and disclosure of my personal information for the purposes of Cart Maintenance Program in accordance with the Freedom of Information and Protection of Privacy Act, (the “Act”). That my personal information will be disclosed to a third-party service provider (i.e. Civic Plus and Smithrite) located in Canada for the purpose of processing my application. That if I have questions about the collection of my information I can contact the Solid Waste Programs Specialist at 604-927-3500 or email Waste Reduction.

Leave This Blank:


65. 1. Receive an email copy of this form.
66. Email address

    This field is not part of the form submission.

67. Submit

* indicates a required field