307 E. Pasadena Freeway Pasadena TX, 77506
Tel: 713-477-0121 Fax: 713-477-2277
Click Here To Go Back                        Scheduling Information

No. Borings: _______ Depth: _______ *Price Quoted: _______

*Additional Charge of $4.00 per traveled mile for projects located outside our 25 mile radius.
** Very important : Engineer must be informed of any tree removal in area of proposed structure. This will be a factor in determining depth of borings and piers.
*** Coastal Testing Laboratories is not responsible for tire ruts.

Name: ___________________________________________ Date: ____/____/____
Mailing Address: ______________________________________________________
City, State, Zip: _______________________________________________________
Phone: _______________ Fax: _______________
Circle One: Building Residence Add-on or _____________________
Project Location: ____________________________________________________
                                   Street Address                                                  City

** Send Key Map location and/or directions to property. We also need to be informed of any special features, i.e. locked gates, etc.

Billing Information
Check one:
_____ Pay full amount prior to drilling - fax/mail the report at completion.
_____ Pay 1/2 prior to drilling and balance upon completion of report.
_____ Existing Account - Please invoice. (Payment due in full within 30 days of invoice date)
Results are not released until report is PAID IN FULL. To open an account, request credit application and fax back to (713) 477-2277 a.s.a.p.

Three reports, signed and sealed by the engineer will be presented upon completion. Have Person responsible for authorizing payment sign below:

Print Name: _______________________ Signature: _________________________
Special Instructions: __________________________________________________


*There will be an additional charge for hand delivery of reports.