You must have JavaScript enabled to use this form. Your Contact Details Name Company Phone number Address Postcode Country E-mail Your PFAS Challenge Type(s) of firefighting foam currently held AFFF (Aqueous Film-Forming Foam) Protein foam Synthetic foam Other… Enter other… Estimated Quantity Quantity Unit - None -KgLiterM3TonUnity Does your foam contain the following PFAS compounds? Questions Yes No Uncertain PFOA Yes No Uncertain PFOS Yes No Uncertain PFHxS Yes No Uncertain Projected Timeline - Expected disposal / replacement date Your message Tell us more about your PFAS challenges Attachment(s) Attachment (optional) file types: JPG, PDF, PNG, GIF / up to 8 Mot(s)Maximum 5 files.8 MB limit.Allowed types: gif, jpg, png, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, zip. Action Personal Data Protection Act By submitting this application form to Veolia, I hereby warrant that all information I have submitted in this form is true and accurate to the best of my knowledge. I further understand that any personal data which I have provided in this form may be proceed by Veolia or any of its vendors and/or subcontractors ("Veolia's connected entities") both locally and overseas and I expressly consent to such processing for the purposes specified in Veolia's Privacy Policy. Please refer to Veolia's Privacy Policy for more details. I understand that any personal deta disclosed by me herein will be retain by Veolia's connected entities as long as any of the purposed set out in Veolia's Privacy Policy remain valid. By completing this form, you give your consent to the collection and use of the personal data that concern you. Read all the disclaimer.
