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GENERAL QUESTION
Job Title
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Business Name
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What is Your Question?
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Current Position
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Select Services Needed
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Hazardous Waste Disposal
Non-Hazardous Waste Disposal
Lagoon / Pond Cleanout
Tank / Pit / Sump Cleaning
Vacuum Truck Services
Lab Pack / Chemical Disposal
Asbestos Removal
Remediation / Soil Cleanup
Plant Shutdown / Industrial Cleaning
Emergency Spill Response
Not Sure — Need Assessment
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Describe Materials Involved
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e.g. sludge, wastewater, haz waste, drums, PFAS, solvents, debris, oils, unknown
Approx Quantity / Volume
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e.g. # of drums, gallons, cubic yards, lagoon size, tank volume
Organization Name
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Site Address
What's Your Timeline?
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Emergency
Immediate (24–48 hours)
Within 1–2 Weeks
Within 30 Days
During Planned Shutdown
Not Sure / Planning Stage
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