Environmental Marketing Services, LLC
Request For Proposal On-Line Form
To request a proposal from EMSLLC, Please fill out the following fields:
 
Proposal Priority:
Urgent Normal
Low
 
Client Information:
 
Client Name:
Client Title:
Company Name:
Department:
Street:
City: State:   Zip:    
Phone: Fax:          
Cell:              
Email:            
 
Site Information:
 
If same as client information, check here:            
If you have multiple locations, check here:            
 
Company Name:              
Street:              
City: State:   Zip:    
Phone: Fax:          
Cell:              
Email:              
 
Waste Characterization:
 
 
Desciption
Waste Codes (if known)
Liquid
Sludge
Solid
  
1)
 
2)
 
3)
 
4)
 
5)
 
 
Quantity of Material:              
Loading Hours:              
Lift Gate required? Yes
No              
Has analytical been performed? Yes
No              
MSDS available: Yes
No              
Do you have a previous profile? Yes
No              
Is material currently handled by
another environmental company? Yes
No              
If yes,
What is the current price being charged?              
Are you willing to fax EMSLLC current profiles?
Yes
No      
Other Information / Services needed: