Which CV/CC/GC company provided the service?

Select a company Clean Venture, Inc. Cycle Chem, Inc. General Chemical Corporation

Who was your CV/CC/GC representative?

When was this service provided?

Select Month January February March April May June July August September October November December Select Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select Year 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

What service did we provide?

Please select a service Emergency Response Services Industrial Maintenance Labpack Services Laboratory Services Hazardous and Solid Waste Transportation Household Hazardous Waste Programs Oil Reclamation Site Remediation Tank Cleaning/ Closure Training/ Education Programs Treatment/ Storage/ Disposal Services

Please rate the following 1 to 5 (5 being the highest):

Please Rate 1 2 3 4 5 Performance of Office Staff?

Please Rate 1 2 3 4 5 Performance of Field Crew?

Please Rate 1 2 3 4 5 Performance of Driver?

Please Rate 1 2 3 4 5 Appearance of Equipment?

Please Rate 1 2 3 4 5 Quality of Technical Assistance?

Please Rate 1 2 3 4 5 Competitiveness of Pricing?

Please Rate 1 2 3 4 5 Timeliness of Responses?

Please Rate 1 2 3 4 5 Our Overall Performance?

Would you use our services again?

Yes
No
Undecided

Are you currently using another vendor?

Yes
No

If yes, who is the vendor?

What service are you using this vendor for?

Are there any services we are not currently providing?

Do you have any suggestions on how we can improve our performance?

Additional Comments.