Fortify Geotech New Site Classification Request

Site Classification Order/Request Form

Please allow a minimum of 10 business days from scheduling for this work order to be completed.
Full Name *

First Name Last Name
Phone Number *
Your E-mail *
E-mail of third party to receive report, if required
example@example.com
SITE Address *

Street Address

Block & Section

Suburb State

Post Code
Proposed Development?
Please choose from the drop down
Please include any construction plans for the block and upload below

Browse Files
10MB maximum Cancel of
Site Access: Please provide information about current residents/tenants, locked gates, dogs or any obstruction on the site. *
If required, can we access the new building footprint with a vehicle? *

Yes No
Additional information you'd like us to know
Billing information for invoice

Required
Business or Personal Name *
Contact Person for Invoice
Accounts Email to Receive Invoice *
example@example.com
Phone Number
Postal Address

Postal Address

Street Address Line 2

Suburb State

Post Code
I have already received a quoted price *

Yes No Please provide a quote
The price I have been quoted is:
e.g. $1,100.00 ex GST
Approval to proceed

YES please go ahead
PLEASE NOTE: AN INVOICE WILL BE ISSUED FOR PAYMENT IN FULL, PRIOR TO THE REPORT BEING RELEASED.
Online Signature *

By signing this form you have agreed with our payment terms. Clear
Comments or Questions:
Is your site a rural block?

Do you need Effluent Disposal for your block (waste water management)?

Click here Effluent Disposal Form

Don't forget to submit this form.
FORTIFY GEOTECH PTY LTD

Unit 2, 538 Gardeners Road, Alexandria NSW 2015

Phone 02 9188 4033

Email info@fortifygeotech.com.au

ABN: 83 617 486 272
Should be Empty:

Site Classification Order/Request Form

Billing information for invoice