Drilling Request Form

Company Name

Contact Name

Address

Phone Number

Fax Number

Email Type

Email *

Site address and city

PECFA Project?

Yes

Number of Geoprobes with depths

Number of temp wells with depths

Number of Concrete Cores

Number of Concrete Penetrations

Number of Mini Flush mounts

Number of Water samples to be taken

Number of NR141 Wells with depths

Continuous Sampling

Yes

Flush mounts or Stand Pipes & how many of each

Number of 55 gal Drums

Are the wells to be developed by us?

Yes

Traffic control (anything more than cones)

Yes

*Please note that every request submitted electronically will be verified over the phone the same or following day.

764 Tower Drive, Fredonia, WI | Phone: (262) 692-3347