Environmental Design Service
45w134 Raymond Rd
Big Rock, IL, 60511
example@example.com
edssepticdesign@gmail.com
(630) 556-3100
E.D.S Job Form
If you do not work to fill the form call the office. If not, after you fill out this order request, we will contact you to go over details and availability before the order is completed. If you would like faster service and direct information, please contact us at (630) 556-3100 or edssepticdesign@gmail.com. Some fields are required and some fields do not require a response.
Customer Details:
Type of Job
*
New
Repair
Tear Down
General Consultation
Please List Anyone/Orgnaization that Refered You to EDS
Client Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Property/Permanent Index Number(PIN)
14 Digit Pin Number (Without Spaces or Indents)
Acres of Property
What Type of Property is This?
*
Residential
Commercial
Other...
Number of Bedrooms
*
1
2
3
4
5+
Number of Bathrooms
*
1
2
3
4
5+
Number of People Living in the Home (This information is confidential)
1
2
3
4
5
6
7
8
9
10+
Basement Depth
8'
9'
10'
Other Applicable Items
Crawspace
Walkout Basement
Garbage Disposal
Pool
Other Structures On-Site
Number of Employees
*
Number of Employees at Any Point in Time
Number of Public and Private Bathrooms
*
1
2
3
4
5+
Number of Guests
*
Number of Estimated People Visiting Facility at any Point in Time
Number of Meals Per Day
If Applicable, Number of Meals Provided
Upload Your Plat of Survey in PDF Format - Call Your County or EDS with Questions
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Please attempt to upload a plat of survey in order to avoid us reaching out to you for this or charging for the obtaining of this information.
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of
Engineering Firm, Surveyor, Soil Scientist or other Professionals You Are Working With.
We will need to optain applicable surveys, engineering plans, soil investigations, photos and other items. Any information you provide here will cut back on us reaching out on your behalf.
Other Information Related to Your Project
Give details about your property, location, point in the process, accessibility, well information, etc.
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