Advanced Radon Order Form

Inspection Address (full address please, include City, State, Zip)

Street Address

Street Address Line 2

Who is this test for? (usually the Home Buyer)

First NameLast Name

Email for the person listed above

buyerName@yourEMAIL.com

Phone Number for the person listed above

Area CodePhone Number

Name of person placing order- Buyer's Realtor, Home Inspector, OR Broker

A person who is ordering for another and will also be sent the test results.

Email of person placing order- Buyer's Realtor, Home Inspector, OR Broker

example@example.com

Phone Number of person placing order- Buyer's Realtor, Home Inspector, OR Broker

Area CodePhone Number

Home Owner, Builder, or Seller's Name

Do you already have the Home Inspection Scheduled?

DateHourMinutesAM/PM Option

Multiple Monitor Consideration - If the lowest usable level of the home is larger than 2000 square feet, or if the home has different foundations (where one test location may not be representative of radon concentrations in other areas of the home), an additional monitor is needed to meet protocol. This is important for split levels or homes with more than one foundation type - you may not be getting the whole picture measuring over only one of the foundations. (If unsure, just ask or leave these boxes unchecked)

Private Well Testing for Radon in Well Water - If elevated radon in air is found, EPA says testing the private well for radon in water is necessary. You can also test the well volitionally for additional peace of mind. https://archive.epa.gov/water/archive/web/html/basicinformation-2.html

Any special requests or additional information about this Radon Test:

IMPORTANT** Please advise the builder, superintendent, or occupant of the home that we will be conducting a Radon Test at the home. We need them to please keep the windows shut & keep the opening and closing of exterior doors limited to less than a minute at a time. These "closed house conditions" need to start at least 12, but preferably 24 hours, leading up to the start of the test and be maintained until the test is completed and the Radon Monitor has been retrieved. I will put anti tampering measures in place and leave a non-interference form for the occupant to review and sign. If the house has any construction or workers coming and going - it's not an ideal the time to schedule a Radon Test as they often ruin the closed house conditions which are necessary for a Radon Test, potentially making a test inconclusive. The test does not conclude until I retrieve the machine, and it is removed along with all signage and anti-tampering stickers.

Make sure you confirm the last bullet point & then hit submit to finalize.

You should see a confirmation screen next once it is done.

Advanced Radon - Test Request Form