Form 5900-502 Service Provider Directory Contact Information Form

EPA’s Voluntary Methane Challenge and Natural Gas STAR Programs

Service Provider Directory Form

Service Providers

OMB: 2060-0722

Document [docx]
Download: docx | pdf

Service Provider Directory Contact Information Form (Web Form)

This form should be completed by companies that are interested in being added to the Natural Gas STAR Service Provider Directory.

Field Name

Data Type

Required

Notes

First Name

Single Line of Text

Yes

First name of company point of contact

Last Name

Single Line of Text

Yes

Last name of company point of contact

Company/Org Name

Single Line of Text

Yes


Street Address

Single Line of Text

Yes


City

Single Line of Text

Yes


State

Single Line of Text

Yes


Zip/Postal Code

Single Line of Text

Yes


Country

Dropdown List

Yes


Email Address

Single Line of Text

Yes

Email address for company contact

Phone Number

Single Line of Text

Yes

Phone number for company contact

Fax Number

Single Line of Text

No

Fax number for company contact

Website Address

Single Line of Text

No

Company/org website

Services Description

Multiple Lines of Text

Yes


Service Category

Multiselect

Yes

Identify applicable service categories

Service Category Other

Single Line of Text

No

Identify service categories not listed

Emission Sources

Multiselect

Yes

Equipment/Technology to Mitigate Methane Emissions From:

Emission Sources Other

Single Line of Text

No

Identify emission sources not listed

Technology

Multiselect

No

Identify applicable technologies

Technology Other

Single Line of Text

No

Identify technologies not listed

Applicable Segments

Multiselect

Yes

Identify applicable sector(s)

Would You Like to Receive Email Updates?

Yes/No

Yes




NOTE: EPA created the Service Provider Directory to share information on service and technology providers that can facilitate methane emission reduction activities, not to endorse particular companies or products. Providing contact information and links to non-EPA websites does not constitute an endorsement by EPA or any of its employees.



EPA Form Number 5900-502

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorLau, Patrick
File Modified0000-00-00
File Created2021-07-05

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