PRE-INSPECTION QUESTIONAIRE

Customer No.: Your Name: Address: City: State: Zip Code: Phone: Email: Email (please verify): How old is your house? How long have you lived there? How long has the water problem been going on? Where does the water appear to be coming in? (select all that apply) thru a wall crack up from a crack in the floor where the floor and walls meet thru a basement window Other (define): Do you know if any type of repair has been attempted in the past? If yes to above, briefly explain: Do you have a sump pump in the basement? What are your plans for the basement? Please define below: Is your neighborhood prone to wet basements? Do other neighbors have a similar problem or is your house the only one? Did someone refer you to our company ? If yes, by whom: When would you like the work to be done? Has anyone else made recommendations as to a plan of repair? How is the grade of the land around your foundation? What is the most amount of water to ever flood the basement? Is your basement presently finished off? Print this form and deliver to your System Design Specialist upon his arrival