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SITE DATA REQUEST FORM
Please complete the following site data questionnaire.
Project Name
Contact Name
*
Number
*
Project Location (US State, Country Name & Province)
*
Email
*
Level of Proposal Effort
*
Fast/ Informal
Defensive/ Preliminary
Final/ Full Scale
The following Questionnaire, when completed, provides the minimum information required to adequately provide an additive based quotation:
cVOCs MIN
cVOCs MAX
Provide Additional Comments
TPH MIN
Other MIN
TPH MAX
Other MAX
Geology
Depth to Groundwater – feetbgs
Bottom Depth of Impact – feetbgs
Treatment Zone Width - feetbgs
Top Depth of Impact - feetbgs
Treatment Zone Length – feetbgs
Application Purpose
Proof-of-Concept (PRS)
Treatability Study
Full-Scale Remediation
Provide Additional Comments:
NAPL Assumed Present
YES
NO
Provide Additional Comments:
Site Conditions
Effective Porosity
(TOC) Naturally Occurring
Other
Provide Additional Comments:
Sensitive Receptors
YES
NO
Provide Additional Comments:
Remedial Goals
Drinking Water Standards
MDLs
Provide Additional Comments:
Summary Data Tables/Site Plan (Choice a file vía e-mail to: service@avilaprime.com)
Please provide historical analytical data and geochemistry information as attachments. (.jpeg, .doc, .docx or .pdf)
Email
Submit
