Request for Technical Assistance

Please complete the following form to request free technical assistance. To qualify for assistance, your business must be based in Georgia and employ 100 individuals or less corporate wide.

1. Tell Us About Your Company [Required]

2. How Can We Help? [Required, check all that apply]

3. Help Us Get Started Quickly [Optional, but will give your request priority]

By providing the following process information up front, GA SBEAP can more quickly address your assistance needs.

a. Describe process steps:
b. Describe raw materials used:
c. Enter raw material input rates: (e.g., lbs per hour, lbs per day)
d. Describe products produced:
e. Enter production rates: (e.g., lbs per hour or lbs per day)
f. Describe byproducts produced:
g. Describe the type and nature of environmental releases that result from operational processes: (e.g., air emissions, wastewater discharge)
h. What is the source of the release?
i. At what process step does the release occur?
j. Identify where release is sent (e.g., is vented to outside, to dust collector, to sewer line, to waste storage drum)?

4. Send Your Request for Assistance

Once we receive your request, a technical assistance team member will contact you to confirm your request. Customers receive assistance in the order the request is received. Priority assistance may be given to businesses that have a pending enforcement action.

Georgia SBEAP offers free technical assistance to Georgia businesses employing 100 individuals or less corporate wide.

Contact Us

toll free (877) 427-6255

metro area (404) 362-4842

fax (404) 363-7100

a. Contact name:
b. Title:
c. Email:
d. Primary phone:
e. Primary phone type:
f. Secondary phone:
g. Secondary phone type:
h. Fax number:
i. Are you a consultant seeking assistance on behalf of a client?	Yes No
If yes, complete the rest of this form with your client's information.
j. Has GA SBEAP provided assistance to you in the past?	Yes No
k. Is this an existing business or a proposed start up?	Existing Start up
l. Company name:
m. Location address:
n. Mailing address: (if different from above)
o. Georgia County of operation:
p. Company web site:
q. Describe your business service or products: (e.g., auto repair, ready-mix concrete)
r. Primary SIC or NAICS code:
s. Number of employees at this location:
t. Is the business part of a larger corporation?	Yes No
u. If yes, what is the number of corporate employees?
v. Is the facility considered a major source of air pollutants?	Yes No Not sure
w. Describe your business operating schedule in hours/day, days/week and weeks/year:

	a. I have received an environmental enforcement action or other communication indicating that my business may be out of compliance.
	b. I need to determine if my business requires an environmental permit or is required to submit a registration or notification to the Georgia Environmental Protection Division (GA EPD).
	c. Indicate the type of permit, registration or notification needed (check all that apply):
	Air Wastewater Storm water Hazardous waste management Solid waste management CERCLA/EPCRA Other
	d. I need help in preparing a permit application or other required forms.
	e. I would like for someone to review my permit application or other information before sending to GA EPD.
	f. I want to know the status of my permit application.
	g. I need help complying with my current permit(s).
	h. Identify the permit(s) you need assistance with including permit number, permit type (air, water, etc), and issuing agency (US EPA, GA EPD, etc):
	i. I would like an on-site compliance assessment of my business.
	j. I am interested in information on waste minimization/reuse/recycling.
	k. I am interested in information on pollution prevention (e.g., energy efficiency, water efficiency, etc.)
	l. If necessary, provide additional details on the type of assistance you are seeking: