| Environmental Assessment
Order Form |
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| 1. |
CLIENT INFORMATION |
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Company:__________________________________________________________ |
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NAME: __________________________________DATE:_______________________ |
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SIGNITURE: X_________________________________________________________ |
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PHONE NO:____________________________FAX
NO:_________________________ |
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| 2. |
SUBJECT SITE INFORMATION |
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| ADDRESS: |
________________________________Street/Avenue/Boulevard/Drive/Place |
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City__________________ State_____________ Zip
Code_____________ |
| Single Address ( ) |
Multi-Addresses (
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Building Story (
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| Year Built (
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Lot Size (
)SF |
BuildingSize ( )SF |
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| 3. |
PRODUCT SELECTION |
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| ( ) |
Transaction Screen Assessment
(TSA Report by ASTM-STD E-1528) |
Cost: $ |
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Site Reconnaissance, EAA
Inspection Report with site photos,
Environmental Government Records, Site Map, Site Plot
Plan,
Conclusion, and Recommendation. |
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Environmental Site Assessment
(Phase I Report by ASTM STD E-1527) |
Cost: $ |
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Site Reconnaissance, EAA
Inspection report with photos,
City Record (and/or County Record), Environmental Government
Records,
Hydrogeology Study, Historical Tenant Report, Site Location
Map,
Site Plot Plan, Conclusion, and Recommendation.
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Site Investigation (Phase
II) |
Cost: $ |
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Review Phase I Report, Workplan
of Soil/Groundwater/Chemicals Sampling,
Representative Sampling, Sample Preservation by EPA Methods,
Chain-of-Custody,
Sample Analysis By EPA Methods, Evaluation of Lab Results,
Conclusion, and Recommendation. |
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Site Remediation (Phase III) |
Cost: $ |
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Review Phase II report, Cleanup
Workplan, permits, cleanup fund application,
remedial actions, inspection, final report, and etc. |
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| 4. |
SPECIAL REQUIREMENTS |
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_________________________________________________________________________ |
| 5. |
CONTACT PERSON |
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