Stack Testing Firm Directory Profile

Stack Testing Firm Directory Profile - Annual Fee $500 USD
For Firms With One Or More Office Locations

Mailing & faxing instructions are included below.

< Previous Page

Important - Write Clearly or Type In

ANNUAL BILLING INFORMATION This WILL NOT appear online.

Do you have a paid Basic or Premium listing on ActiveSET.org right now?		No, this is a new order.
		Yes, we want to upgrade to a Directory Profile. Please prorate our current account with an extended annual renewal date.

Send our receipt and placement confirmation to this e-Mail address:

___________________________________________________________________________________________________________
(This address will NOT be given, sold or leased to 3rd Parties)

Billing Street or P.O. Box: ___________________________________________________________________________________

City: ______________________________________________________________ State/Prov: ____________ Zip: _____________

Free Logo
Preparation:

Scan our logo from our website
We are sending a digital logo attached to e-Mail addressed to webmaster@activeset.org
We are mailing a scannable color logo with our order (artwork cannot be returned)

DIRECTORY PROFILE INFORMATION This WILL appear online.

Main Office Listing

Company Name: ____________________________________________________________________________________________

Street Address: _____________________________________________________________________________________________

City: ______________________________________________________________ State/Prov: ____________ Zip: _____________

Mailing Address (If different): _________________________________________________________________________________

City: ______________________________________________________________ State/Prov: ____________ Zip: _____________

Each of your additional offices will be given a FREE Premium Directory Listing:
I have attached addresses for additional office location(s). ... N/A, we have only one office location.

Phone (Area code): ______________________________________ Fax (Area code): ____________________________________

Toll Free: ___________________________________________________ or N/A

Web Address: http:// ________________________________________________________________________________ or N/A

Contact’s Name: ____________________________________________________________________________________________

Contact’s e-Mail Address: ____________________________________________________________________________________

Year Established: _____________

Testing Staff Size: _______________

No. of V.E. Readers __________

Ambient Air Monitoring Capabilities? Yes .. No

Geographic Testing Area:

U.S. & International

U.S. Only.

Canada Only

Limited Area (enter states/prov. below)

__________________________________________________________________________________________________________

U.S. EPA Testing Capabilities: All Methods Listed .. Selected Methods Only
1-4	5	5A-H	6	6A-C	7	7A-E
8	9	10	10A-B	11	12	13A-B
14	15	15A	16	16A-B	17	18
19	20	21	22	23	24	24A
25	25A-B	26	26A	27	28	28A
29	101	101A	102	103	104	106
108	111	201A	202	301	306
SW-846 Methods		BIF Methods		NIOSH Methods

Add'l U.S. EPA Methods: _____________________________________________________________________________________

Add'l Gaseous Monitoring Parameters/Specialties: ______________________________________________________________

____________________________________________________________________________________________________________

On-Site Sample Analysis/Titration:

SO2

Pm10

HCl

Other - List below:

___________________________________________________________________________________________________________

Industries Served:
All Industries - Asphalt, Soil Remediation, Cement, Manufacturers, Food & Beverage, Pulp & Paper, Power Generation,
Medical and Municipal Waste Incinerators, Petroleum/Fuel, Printing and Packaging, Sugar Mills.

Add'l Industries: ____________________________________________________________________________________________

These Industries Only: ____________________________________________________________________________________

__________________________________________________________________________________________________________

Gaseous Monitoring Dilution System? Yes .. No

No. of Mobile Labs: _______

No. of Isokinetic Sampling Trains: _______

Provide a short paragraph describing your COMPANY OVERVIEW:

Provide a short paragraph describing your COMPANY EXPERTISE:

Provide a short paragraph describing your COMPANY SPECIALTIES:

PAYMENT OPTIONS The annual fee is non-refundable after your order has been placed on ActiveSET.org.

OPTION 1 - Pay By Check
Mail the completed form with a U.S. Check or Money Order in U.S. Funds for the $500 annual fee payable to:
ActiveSET.org 3335 NW 47th Terrace Gainesville, Florida 32606

OPTION 2 - Pay By Credit Card

Mail the completed form to:
ActiveSET.org 3335 NW 47th Terrace Gainesville, Florida 32606

Fax the completed form to:
(352) 375-3759

I authorize Emissions Schematics to bill my credit card $500 (USD) for the annual fee. ActiveSET.org is owned and
operated by Emissions Schematics. Your credit card will be billed as "Emissions Schematics"

Cardholder's First and Last Name as it appears on the front of the card:

____________________________________________________________________________________________

Credit Card Number:

____________________________________________________________________________________________

Expiration Date - Month: _____________ .. Year: __________

Thank You ! ActiveSET.org will process your order immediately upon receipt.
By submitting this order you agree to the terms and conditions of the ActiveSET.org Advertising Services Agreement
ActiveSET.org Customer Service: order@activeset.org