COASTAL TESTING LABS., INC.
Tel: 713-477-0121 Fax: 713-477-2277
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No. Borings: _______ Depth: _______ *Price Quoted: _______
*Additional Charge of $4.00 per traveled mile for projects located outside our 25 mile radius.
Name: ___________________________________________ Date: ____/____/____
** Send Key Map location and/or directions to property. We also need to be informed of any special features, i.e. locked gates, etc.
_____ 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: _________________________
*There will be an additional charge for hand delivery of reports.