Leak Goforth Company, LLC

SITE SELECTION QUESTIONAIRE
Name of Company
Address
City, State and ZIP
Project Description

GENERAL REQUIREMENTS

Geographic area of consideration

Population Range of City

Start up date

Union status of project

List five most important factors in order of importance:

List other important factors to be given consideration:

PLANT AND PROCESS INFORMATION
Industry type

Type of Process

Specific Products

Major by-products:

Major raw materials:

Proposed plant size:

Proposed site size:

Proposed warehouse size:

Proposed office size:

CAPITAL INVESTMENT AND INVENTORY VALUE
Land

Buildings

Production machinery and equipment

Pollution control equipment

Raw materials

Goods in process

Finished goods

TYPE OF CONSTRUCTION
Building material

Special Feature

LABOR REQUIREMENTS

Hourly Wages

	Number	% Male	Min.	Max.
Unskilled
Skilled
Prof/Managerial
Total

List Types of Skills

Number and types of personnel to be transferred into this location

SERVICES REQUIRED

Electric Power	Start	Peak
Energy kwh/yr
kw demand
Dual feed desired? Yes No

Natural Gas

Cubic feet/yr.

Cubic feet/hr.

Municipal water supply desired? Yes No

Municipal waste treatment necessary? Yes No

List and specific telecommunications needs:

TRANSPORTATION

Approximate tonnage to be shipped and received by:

Truck Rail

Air Water

Channel depth needed feet

Desired distance to ocean port miles

Desired distance to commercial airport miles

Airstrip for private planes important? Yes No

IF EXISTING BUILDING IS DESIRED
Size	Stories	Preferred Dimensions
sq.ft.
Ceiling Height	Column Spacing	Percentage of area heated
feet
Air Conditioned	Sprinklered

Outside area needed for parking, storage, other

Special Requirements(floor thickness, etc.)

Truck docks/Drive-in doors

ENVIRONMENTAL WASTE AND WASTE WATER

Amount of water to be used Gallons per day

Purpose (gpd)

Domestic Process

Cooling Other

Wastewater discharge

Describe characteristics of wastewater

AIR EMISSIONS

pollutant emitted	Emission rate (tons/yr)

SOLID WASTE

Type of solid waste	Hazardous / non-hazardous	Amount (tons/day)	Disposition desired

Any low level radiation waste produced at this site?

Other comments that will help locate the optimum site:

PLANT AND PROCESS INFORMATION

CAPITAL INVESTMENT AND INVENTORY VALUE