INCIDENT REPORT

The health and safety of our team members and the communities we serve is our first priority each and every day. We implement comprehensive behavior-based safety systems across the entire enterprise and work tirelessly to build and improve through training, technology, and consistent oversight.

If you have been involved in an incident, please fill out this form and one of our Risk Claims Adjusters will contact you.

Accident photos, videos, and insurance card MUST be sent to Risk and Safety Department via email riskmanagementgroup@interstatewaste.com

Type of Incident:(Required)

Motor Vehicle

Property

Injury

Spill

Claimant First Name:(Required)

Claimant Last Name:(Required)

Claimant Phone Number:(Required)

Claimant Email:(Required)

Date Incident Occurred:(Required)

Time Incident Occurred:(Required)

Address of where incident took place:(Required)

Include borough and intersection if applicable

Brief description of incident:

Was a Risk business card provided:(Required)

Yes

IWS Truck/Equipment #:

IWS Truck License Plate:

CAPTCHA

INCIDENT REPORT

1-866-DIAL-IWS

1-866-270-9900

1-866-DIAL-IWS

1-866-270-9900