SC DHEC Cleanup Contractors and Vendors Survey Form
Complete this form to add your organization to the list of cleanup contractors and vendors maintained by the SC Department of Health and Environmental Control.

Please enter a value for each applicable field. Submitted information should be as complete as possible and formatted according to the guidelines below. The SC Department of Environmental Control reserves the right to edit or omit any erroneous or invalid entries.

Please do NOT include special characters or character returns in any response.

Company Name
Enter your organization name as you would like it to appear in the list.
Your answer
Street Address
Enter the physical street address of your organization. If applicable, provide an address within the State of SC. PO boxes should not be included and will be omitted in the listing. The address should be formatted similar to this example: 123 Roadway Dr, Columbia, SC 12345.
Your answer
Point of Contact
The name of a primary point of contact may be entered here, if applicable.
Your answer
Email Address
Enter an email address, if applicable, in the format provided in the following example: person@company.org
Your answer
Website
When entering a web address, include the complete URL. If you are unsure of the URL, navigate to your page and copy the content of the address field from your browser. The complete web address should look similar to the following example: http://www.scdhec.gov/
Your answer
Phone Number
Enter the 24 hour emergency response phone number, if applicable, or the primary number for your organization. The 10 digit phone number should be entered in the format provided in this example: 123-456-7890
Your answer
Principle Line of Work
In this field, add information regarding the primary operations and any specializations of your organization.
Your answer
Service Catagory
Select one or more service categories.
Response Area
Enter a list of counties, seperated by commas, or enter Statewide, if applicable.
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service