Pole Request Form

Pole Request Form
This form is for poles only!
Contact Information *Indicates required fields
First Name*				Last Name*
Company				E-mail Address*
Phone Number (INCLUDE AREA CODE)				Fax Number (INCLUDE AREA CODE)
Quote Information
Species		Specification		Framing
Coastal Douglas Fir Western Cedar Southern Yellow Pine Lodgepole Pine Red Pine		ANSI/AWPA		M20
		RUS		Roof and Brand
		Other (Specify)		Other (Specify)

Delivery Instructions Ship To:
City				Zip
Type of Delivery
Self-Unloader Flatbed Rail Customer Pickup
Treatment
Full Length Butt Treated (Cedar Only) Untreated
Preservative
Penta Creosote CCA CA-B
Retention Level
Independent Inspection: Yes No WQC
Inspector
Product
Note: If you have more than ten items to enter, check here
Quantity	Class or Top Diameter		Length
1
2
3
4
5
6
7
8
9
10
Notes or Questions