Collection Program Return Request Form

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COLLECTION PROGRAM - RETURN REQUEST FORM
I have read and agree to with the terms of the Conditions Agreement
found on Collection Program Return Request.

Company Name

Address

City

State

Zip Code             Phone Fax

Contact Name

E-Mail

Pickup Hours     to Quantity of IBC's

Last Chemical Trade Name/Number (HazMat Only)

Comments


Name

Title

Links

RIPA

Online Scheduler

IMACC SharePoint

49 CFR - DOT

Hazardous Material Regulations

Qualification and Maintenance of IBCs

IBC Regulations

Closure Instructions

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Locations

IMACC Corporation
2303 Dalton Industrial Ct
Dalton, GA 30721-4901
706.270.8635 Ph
706.259.8071 Fax

IMACC Corporation
1236 Industrial Ave
Suite 101
Gastonia, NC 28054
704.874.1210 Ph
704-874.1208 Fax

IMACC Corporation
1435 W. Church St
Jacksonville, FL 32204
904.233.6693 Ph
706.259.8071 Fax

IMACC Corporation
7835 National Turnpike Suite 100
Louisville, KY. 40214
502.314.6856 Ph
502.368.0130 Fax

Map Directions
   Dalton
   Gastonia
   Jacksonville
   Louisville