IT/E-Waste Disposal Site Information Pickup Form

"*" indicates required fields

Estimated number of pieces to be picked up

(In order to recieve a proper logistics quotation, it would be helpful to have an approximate breakdown)

Devices over 100+ lbs
Please list details in "Other" below

Data Wiping Services:*
NIST 800-88 Data Wiping/Destruction Services (please check box): Please select (if none selected - Data Wipe Service is declined)
* If data wiping services are declined, customer shall indemnify and hold harmless AnythingIT, LLC.
If yes, place Maximum Size
Will you require assistance with onsite packaging?
Will you require assistance with onsite packaging? If no, please be advised equipment must be packaged on pallets and shrinkwrapped
Can equipment be de-installed and put into a central location for packing & pickup?
Can equipment be de-installed and put into a central location for packing & pickup?
Is there room onsite to shrink-wrap and palletize?
Is there room onsite to shrink-wrap and palletize?
Does the facility have a loading dock?
Does the facility have a loading dock?
Does the facility have a freight elevator?
Does the facility have a freight elevator?
Do you have a pallet jack or forklift at your location?
Do you have a pallet jack or forklift at your location?
Does the facility have a public elevator?
Does the facility have a public elevator?
Work to be done durning normal business hours (Mon-Fri / 9am-5pm)
Work to be done durning normal business hours (Mon-Fri / 9am-5pm)
Will a property pass be required to remove equipment?
Will a property pass be required to remove equipment?
Do we need to schedule time to use the loading area?
Do we need to schedule time to use the loading area?
Are there any specific security issues with gaining access to your facility?
Are there any specific security issues with gaining access to your facility?
Does your facility require a Union laborer to provide onsite services?
Does your facility require a Union laborer to provide onsite services?

BE ADVISED: A separate form MUST be completed for each location. Pickup dates may be requested but are not guaranteed. For all media where data destruction services are declined, customer shall indemnify and hold harmless AnythingIT, LLC.
Please direct any questions to sales@anythingit.com

Thank you for your assistance in providing the above information.