Remediation Contact Company InformationCompany Name* Address* Street Address City State / Province / Region ZIP / Postal Code Phone*FaxEmail Referrer Type*Choose oneGoogleYahooBingLinkedInFacebookInstagramTrade ShowReferrals or FriendsReturning CustomerOtherProject OverviewSite name* Site location* Remediation system preference* Ozone Oxygen Combo injection Ex-situ oxidant LINJ Other/Custom Equipment application* Pilot study Full-scale Both Unit enclosure* Mobile trailer Floor mount Options* Telemetry Auto-dialer Ozone monitors Transaction type* Rental Lease-to-Own Purchase Project funding source* State fund Private insurance Other Other funding source Desired clean-up timeframe*MonthsEstimated rental period (if applicable)MonthsBriefly describe site clean-up goals*Summarize the current regulatory program status*If custom, give a brief description of the desired system specifications*Site Specific ConditionsPlease complete the following based on current data.Soil lithology Bulk densityg/cm3GroundwaterEstimated contamination areasq. ft.Depth of contaminationft.Depth to groundwaterft.pHAverage groundwater temperatureºFContaminantConcentration (mg/L)TPHgTPHdBenzeneEthylbenzeneTolueneXylenesMTBETBATCE/PCEPAHsOther Contaminant Concentration (mg/L) BackgroundMineral/GWConcentration (mg/L)IronManganeseTOCCODVadose zoneEstimated contamination areasq. ft.Depth of contaminationft.ContaminantConcentration (mg/kg)TPHgTPHdBenzeneEthylbenzeneTolueneXylenesMTBETBATCE/PCEPAHsOther Contaminant Concentration (mg/L) Background Mineral/SoilConcentration (mg/kg)IronManganeseTOCCODEnter the characters you seeEmailThis field is for validation purposes and should be left unchanged.