Environmental Site Assessment Form

A TEC staff member will call you should we require further information to develop your Phase I ESA proposal. For a Phase II ESA, please call the Environmental Assessment Department at 248-588-6200.

Fields with an * are required.

Requestor Information:
* Name:
* Company:
* Address:
* City, State, Zip:
* Phone Number:
* Fax Number:
* Email:
   
* I am the:  






* Report-Turnaround-Time:

* I Need-Proposal-By:

* I would like to be contacted by:


Site Information
Multiple Sites (a TEC rep will contact you for additional site information)
Site Name:
Address:
City, State, Zip
Size of Lot:
Size of Building:
  Year Built:
  Number of Tennants/Units:
  Number of Floors:
  Site Contact, Name:
  Site Contact, Phone
* Current Use-of-Site (check all that apply):
• Residential
  Single Unit Vacant
  Multi Unit  
     
• Commercial
  Gasoline Station Vacant
  Dry Cleaners  
  Retail  
  Office  
  Warehouse  
  Restaurant  
  Grocery  
  Other
     
• Industrial  
  Airport Vacant
  Manufacturing  
  Other
     
• Agricultural
  Crops  
  Livestock  
  Orchard/Grove  
     
Open Space/Undeveloped
     
Other
* Purpose of Phase I:



Type of Other Reports Requested:



I can supply TEC with:



* Lender


Special Requirements/Comments/Questions: