INFORMATION REQUEST FORM

This form is intended as a tool for trade professionals. We encourage persons outside the construction and maintenance industries to forward information on our site to their contractor, builder, or architect.

Not all questions may be relevant to your application but please try to answer each to the best of your ability.

We respect our customer's privacy. The information provided here will be used to ascertain your coating needs only. It will not be sold or passed to anyone not directly involved in the decision process.

1. Product of interest:

Anti-graffiti
Elastomeric Architectural
Roofing
Stain - Concrete or Masonry
Stain - Wood
Application tools and sundry items
Waterproofing
Other

Please provide as many details as possible. Be thorough, there is plenty of space here and at the end of this form.

2. Substrate to be coated is:

If other, please describe:

3. Current condition of substrate is best described as having:

a temporary wax, oil or grease coating
no paint or coating
failure in present coating
failure in small areas
intact but needs renewing
other
If other or 'failure in present coating' is chosen, please describe the present coating or situation here...

4. Which best describes surface to be coated? (check all that apply)

interior
exterior
other...
If other, please explain

5. Height of structure to be surfaced is:

less than 50 feet / 15 meters high
more than 50 feet / 15 meters high
intricate
not applicable

6. Maximum temperature coating will be exposed to:

up to 150°F / 65°C
up to 200°F / 95°C
up to 250°F / 120°C
up to 350°F / 175°C

7. Surface is exposed to condensation:

rarely
occasionally
frequently
continuously while in use

8. Is the surface exposed to concentrated chemical fumes and vapor generated by a local process?

no
yes
If yes, which chemical fumes or vapors?

9. What type of sunlight exposure is typical?

temperate sunshine
subtropical sunshine
tropical sunshine
inside / not applicable

10. How often is the surface washed?

rarely
occasionally
frequently
continuously wet when in use

11. Is the surface abraded?

rarely
mild abrasion
moderate abrasion
severe abrasion

12. The surface:

does not contact food or potable water
has incidental contact with food or potable water
has direct contact with food or potable water

13. The coating system needs:

to be treatable to enhance inhibition of mold and mildew
no special properties for special treatment

14. The minimum ambient temperature in the field during the curing of the coating is:

at or above 55°F / 13°C
32 to 55°F / 0 to 13°C
0 to 32°F / -18 to 0°C
below 0°F / -18°C

15. Generally, the normal relative humidity in the field during the curing of the coating is:

below 15%
15 to 40%
35 to 85%
above 85%

16. What type of ventilation is available during the coating process?

forced ventilation or outdoor
indoor with normal building ventilation
confined spaces with poor ventilation such as tanks or pits

17. Additional information:

Add anything you want here. No detail is considered trivial and no question is unimportant. Please be thorough — there is plenty of room!

All your effort will be lost if we can't contact you.
Required fields are in bold with an asterisk*.

Information should be sent to:

* Mr. Mrs. Ms. Dr.

First Name*

Last Name*

Title

Organization*

Street address*

Address (cont.)

City*

State/Province*

Zip/Postal code*

Country*

E-mail*

Phone*

Fax

Please review your answers before sending.