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Injection Services Proposal Form

In order for Summit to prepare an accurate cost estimate for your drilling project, please fill out the form and submit when you are finished.
Your Contact Info
Company Name:
Contact Name:
Contact Email:
Phone Number:
Fax Number:
Contact Address:
Contact City:
Contact State:
Contact Zip:
Injection Services Project Location
Location Name:
Street Address:
City:
State:
Zip:
Injection Services Project Bid Specs
When do you need this bid?:
Date:
Time:
Number of injection points?
Injection point specs?
Temporary Permanent
If temporary points, what type of Geoprobe machine do you prefer?:
ATV track mounted Geoprobe
Geoprobe 5400
Geoprobe 6600 Dual Probe/Auger machine
What is the targeted depth of injection?:
Minimum Maximum
What is the geology within the targeted depth of injection?
Will there be asphalt or concrete coring involved?:
Asphalt Concrete coring
Both None
What are the remedial products to be injected?
First product:
Total pounds of first product?:
What are the remedial products to be injected? Second product:
Total pounds of second product?:
How many gallons of water are required for mixing the materials?:
What is the solution/slurry concentration to be injected?:
Is water available on-site?:
Yes No
What is the estimated timeframe for this to be completed?:
Please provide a site figure, if available. It can be uploaded via this link:
Additional Comments:



81 Chimney Rock Road, Bridgewater, NJ 08807 Phone: 800-242-6648 Fax: 732-356-1009 © Copyright 2012. Summit Drilling Co., Inc.