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Name

Email

Cell phone number

Year Built

Address

Information about the property we will be performing the mitigation on

Is the property occupied? Is the property occupied? YesNo

Crawlspace present? Crawlspace present?YesNo

Estimated basement sq ft

House Type (e.g. Ranch, 2-story, split level, etc.)

Estimated crawl space sq ft

Foundation material Foundation materialPoured ConcreteFlouting Floor

Exterior finish Exterior finishBrickConcreteStuccoWoodVinylOther

Basement present? Basement present?YesNo

Walkout basement? Walkout basement?YesNo

Percent of basement that is finished

Basement floor material Basement floor materialConcreteWood

Is there crawlspace under the basement floor? Is there crawlspace under the basement floor?YesNo

Is there a boiler system with radiant floor heating? Is there a boiler system with radiant floor heating?YesNo

Is there a sump pump present? Is there a sump pump present?YesNo

HOA Property? HOA Property?YesNo

Radon test results