Step 1 of 5 - Background Information 20% 1. Background InformationSite Information:Site Name:*Site location (town/city/state):*Site Owner/Responsible Party*State regulatory agency overseeing the work:Federal regulatory agency overseeing the work:History of spill and remedial efforts at the site:Environmental Consultant:Name/Company/Phone Number:Email* Preferred proposal deadline:*Preference for a webinar with our technical experts where our evaluation will be presented:YesNo 2. Remedy OptionsWhich remedial options are you currently considering?OptionYesNoComment/Focus 3. Site Conditions and TTZ DefinitionDimensions of TTZ (Target Treatment Zone):1. Treatment area footprint (length x width):*2. Depth or vertical treatment interval if not to ground surface:*3. Estimated treatment volume (cubic yards):*Site Cover/Surficial Conditions:1. Cover Materials (Concrete, Asphalt, Grass, etc.):2. Thickness:3. Surficial Structures or Features (Buildings, high topographic relief):Geology and Hydrogeology Descriptions:Use + to add more rows.Name of layer describedGeology layer/ soil type (e.g. “silty sand”)Top of layer [unit]Bottom of layer [unit]Location of groundwater table [unit]Hydraulic conductivity [unit]Hydraulic gradientSeepage velocity in affected groundwater zones [unit] Please include maps where the target treatment zone(s) are clearly identified.Identify the treatment zone/zones*Include scale bar (verify that scale and quoted area match)*Please include cross-section (s) that clearly define the target treatment zone:Show major layersShow top and bottom of treatment intervalIdentify source zones and plumesPlease include Soil Resistivity (or conductivity) samples from each distinct unit being treated.Dynamic Resistivity Testing Results (Preferred)Static Resistivity Testing ResultsPlease also include relevant information regarding site access restrictions:Building footprints and/or clearance (identify locations on map)Describe foundations and building typeIdentified utilities present within the treatment zone (include map)Do the business operations need to remain active during thermal implementation?What type of operations are there within the business?Can drilling and other related thermal remediation work be done inside the building?Other general information pertinent to business operations and remediation*Other site restrictionsTreatment Equipment (Vapor Phase/Liquid Phase):Please describe existing equipment at the site (include sizes if possible).* 4. COCs and ObjectivesWhat is the overall objective of the remedy?Please list the contaminants of concern and their concentrations in the table below. Press + for more rows.Chemical NameEstimated Mass [unit]Groundwater (mg/L) Max Level DetectedGroundwater (mg/L) Target LevelSoil (mg/kg) Max Level DetectedSoil (mg/kg) Target Level 5. Additional Site InformationUtilitiesUtilitySize/CapacityUsage Cost Per UnitComments If you'd like to print out the questionnaire and complete it by hand, use the download button below. Download