Proudly ServingVirginia

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Contact Info

Company Name: *

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Questionnaire

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What type of industry are you in?

Volume of waste water generated per day?

Reason waste water cannot go down sewer?

Hours of operation: 8 hours 16 hours 24 hours Other:

Do you currently have a waste water system? Yes No

If so, what type?

Please describe the current issues with your system:

Do you currently haul away wastewater? Yes No

Any additional comments: