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UPROAD - NEW CLIENT & PROJECT FORM 1. Identification Data ORGANIZATION NAME Main Activity Tax ID Number Address Phone Website Contact Person Name and Last Name Position Phone Email Other Info Project Details Project Name Surface (m2) Project Location Project Objective Dust Control Soil Stabilisation Anti-Ice Road Monitoring & Management Other 2. What are your goals with ABCDust products and services?  Regarding Dust Control, Soil Stabilization,  Anti-Ice and Road Monitoring & Management? 3. DESCRIBE THE CURRENT ADDITIVES YOU ARE USING TO TREAT YOUR ROAD AND SURFACES? Type (Water, Polymers, Asphatic Emulsion, Chlorides) How often do you apply the additives? What are your application rates? Do you have measured performance for dust levels? I don't knowYesNo Reference Values Do you have measured performance for road regularity? I don't knowYesNo Reference Values Do you have measured performance for road friction? I don't knowYesNo Reference Values Others Comments 4. DESCRIBE THE SURFACE´S AREA THAT YOU WANT TO TREAT Type of Surface to treat Long Wide Depth  (Soil Stabilization Projects) Haul Road Industrial and Access Road Secondary Road Underground Haul Roads Parking Lots Erosion Control (berms, ditch,  shoulders., wall) 5. Weather Conditions Season Provide data (if available) Temp max, Temp min, Temp  Mean, Wind Speed, Precipitations  Spring Summer Fall Winter 6. ROAD DESIGN AND MAINTENANCE Road Shape Inslope OutSlope Crown Flat Underground Mine Road Average Road Grade(%)= Road Materials description:  Hard Angular Rock (top size  bellow 1,5”, well graded) fines present Soft Angular Rocks, top size bellow 1,5”, well graded Hard Angular Rocks, top size bellow 1,5”, poorly graded -no fines to bind Soft Angular Rocks, top size over 1,5”, poorly graded -no fines to bind No rock, only fines Depth Surface Course ASTHO Classification Average Rock Size % Fines % Clay IP Value Depth Base Course ASTHO Classification Average Rock Size % Fines % Clay IP Value Native Course What is your road design structural resistance?  Road Surface Condition: Is the road surface smooth and firm YesNo Is erosion evident on the road surface YesNo If, yes, which type of erosion: Which of the following road deterioration signs are present and how often? Nuts Not observed Rarely Observed Very often All the time Washboard Not observed Rarely Observed Very often All the time Potholes Not observed Rarely Observed Very often All the time Sinking gravel Not observed Rarely Observed Very often All the time Dust Not observed Rarely Observed Very often All the time Low Spot / High Spot Not observed Rarely Observed Very often All the time Large Rocks Not observed Rarely Observed Very often All the time Road Skid / Drifting Not observed Rarely Observed Very often All the time Muddy when rains Not observed Rarely Observed Very often All the time Does the road have:  Berns YesNo 1- Poor Conditions 2-  3- Medium Condition 4-  5- Excellent Conditions Shoulders YesNo 1- Poor Conditions 2-  3- Medium Condition 4-  5- Excellent Conditions Ditch YesNo 1- Poor Conditions 2-  3- Medium Condition 4-  5- Excellent Conditions ROAD MAINTENANCE: How often is the road leveled and compacted? How often is the road reconfigured? How does rain impact your road? How does your snow impact your road? Transit Frequency:  Low (< 10 Trucks/h) Parking Lot Median (10-20 Trucks/h) Bellow 50 kph (30 mph or less) High (20-40 camiones/h) 50 – 75 kph (30 – 45 mph) Continuos (> 40 trucks/h) Above 75 kph (45 mph) Non Transited Surface 7. Vehicule Weight Max (Ton) Average (Ton) 8. AVAILABLE ROAD MAINTENANCE EQUIPMENT Water truck YesNo Quantity and Capacity Irrigation Bar YesNo Quantity and Capacity Grader YesNo Quantity and Capacity Roller YesNo Quantity and Capacity Other Equipment YesNo Quantity and Capacity Submit