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Building Survey Form <br /> Type in or select answers from drop-down lists in the righthand column. <br /> Upload answers to GeoTracker database for criteria marked with an asterisks (*). <br /> See Table 1 in the Guidance on Uploading Vapor Intrusion Information into GeoTracker <br /> (Attachment 4 of Supplemental Vapor Intrusion Guidance) for a description of Building <br /> Design Type input choices. <br /> Person Conducting Survey Input <br /> Name: <br /> Company: <br /> Phone Number: <br /> Email: <br /> Building Contact Information Input <br /> Name: <br /> Contact Title: <br /> Phone Number: <br /> Email: <br /> Building Occupant Interviewed? _ <br /> Building Information Input <br /> Date of Building Survey (dd/mm/yy): <br /> *Building Name: <br /> *Building Address (Street, City): <br /> Coordinates for Center of Building <br /> (Latitude, Longitude; decimal degrees to <br /> 0.00000): <br /> *Building Location Onsite/Offsite with respect to <br /> Site/Facility: - <br /> *Year Built <br /> (yyyy; approximate if unsure): <br /> *Building Occupants: _ <br /> Building Survey Form Page 1 <br />