Company name*
    Are you an owner, purchaser or other?* :
    Other, please specify :
    Site address*
    Lot number(s)*
    Nature of activities on the site* :
    Presence of previous environmental and/or geological studies?* :
    Phone number*
    Secondary phone number
    Do you allow our staff to leave a message or introduce themselves during communications?* :
    Billing address*
    Is it a sale, a purchase, request for financing or other? * :
    Other, please specify :
    Additional info :