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Company / Contact Information

Company Name:*

Company/ Billing Address*

Contact Name:*

Phone:*

Email:*

Project Location:*

KMZ URL (optional)

Proposed Start Date:*

Access Limitations:*

i.e.; Forested area, steep terrain, soft terrain, no access limitations

Rig Types Required:*

Drilling Method:*

Stratigraphy:

Number of Boreholes:*

Estimated Depths:*

Hole Completion Size:*

Sample Type:*

Down-hole Testing Type:

Additional Sampling & Testing Details:

Backfill Criteria:

Bentonite Grout, Bentonite Pellets, Cement, etc.

Installation Type:

Size of Installation:

Protective Cover Type:

Additional Project Details:

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