Submit a Work Order Geothermal Loop Installation Water Well Installation Geothermal Loop Installation Download this form (pdf) Contact Information Contact Name Required Contact Phone Required Contact Email Required Homeowner's Name Homeowner's Phone Homeowner's Email Billing Party Billing Address Billing City Billing State Select a state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Billing Zip Code Jobsite Location Heating Contractor Heating Contractor's Email Date Jobsite Address Jobsite City Jobsite State Select a state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Jobsite Zip Code Heat Pump Brand Loop Field Information Loop Field Type Select an Option Vertical Horizontal Pond Loop Field Options Select an Option Drill-drop & Group Only Header & Bring Pipes Into Building Loop Field Installation Select an Option Retro Fit New Construction Loop Field Size (tons) Select an Option 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 Interior Piping Needed Flush & Fill Needed Work Date Requested Let us know if you would like to get started on a specific date; otherwise, feel free to leave blank Non-Utility Underground Obstructions If you know of any potential underground obstructions, please let us know below; otherwise, feel free to leave blank Special Requests Special Instructions or Requests may add additional costs to your project above our normal price list procedures. Please use the following choices to help us plan a loop field that meets your site requirements with the most performance for the least cost. Upgrades are priced individually and quoted after a site visit or plan review. Building Entry Building Entry Options Let us know if you have any preferences for the method of entry into the building Select an Option Basement Crawl Space Slab Building Entry Type Let us know if you have any preferences for the type of entry into the building Select an Option Open Dig Mole/Directional Bore Drill Cuttings/Spoils Let us know if you have any preferences for how the drill cuttings or spoils should be handled Select an Option Haul Away Leave on Site Excavated Soil Back fill Requirements: Note: Durbin Geothermal properly grouts all vertical boreholes per IGSHPA recommendations and appropriate state codes. This section deals with excavated area for supply and return lines and header connections. Standard Rough Grade Back Fill Dirt mounded on trenches and left to settle naturally, standard procedure unless specified otherwise Compact Excavated Soils Use trench compactor to return site to existing grade, quick landscape restoration Structural Fill Engineered fill for specific compaction needs; driveway, parking lot, etc Partial Compaction/Granular Fill Part of the loop field will require compacted fill, loop crosses sidewalk/driveway Ignore this input field, leave it empty Water Well Installation Download this form (pdf) Contact Information General Contractor's Name Required General Contractor's Phone Required General Contractor's Email Required Well Owner's Name Well Owner's Phone Well Owner's Mailing Address Date Jobsite Location Jobsite Address Jobsite City Jobsite State Select a state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Jobsite County Jobsite Zip Code Water Well Information Expected Casing Depth Material Type Select an Option PVC Steel Expected Total Depth Stop Drilling Depth Latitude Longitude GPM Required Ready Now Expected Date Ready Casing Hole Full Length