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Pull Test Request Form

JOB NAME:

LOCATION:

CITY:

STATE:

ZIP:

DATE NEEDED:

IDEAL TIME:

APPROXIMATE SQUARES:

DECK TYPE:

Please check ALL that apply:


FASTENER SPECIFIED:

NEW SYSTEM MANUFACTURER:

NEW BASE SHEET CHOSEN:

ONSITE CONTACT NAME/COMPANY:

CELL PHONE NUMBER:

ROOFER / COMPANY PROVIDING ACCESS AND REPAIRS:

PHONE NUMBER:

NOTE: TRUFAST CANNOT PROVIDE ROOF-TOP ACCESS. YOU MUST PROVIDE NECESSARY ROOF ACCESS AND A LICENSED ROOFING CONTRACTOR TO CUT AND PATCH TEST AREAS. WE ARE NOT RESPONSIBLE FOR ROOF DAMAGE OR LEAKS. WE STRONGLY RECOMMEND YOU HIRE A ROOF CONSULTANT AND ENGINEER FOR CORE SAMPLING, STRUCTURAL INTEGRITY, CODE REQUIREMENTS, WARRANTY COMPLIANCE, ULTIMATE FASTENER SELECTION AND FASTENER DENSITY. COMPLETING THIS FORM INDICATES YOU WILL BE RESPONSIBLE FOR ANY ROOF DAMAGES AND REPAIRS AND WILL ABIDE BY THE LIABILITY GUIDELINES ON OUR WEBSITE.

REQUESTER/COMPANY:

PHONE NUMBER:

FAX NUMBER:

E-MAIL ADDRESS:

ADDITIONAL COMMENTS:

REFERRED BY: