Evans Service Company, LLC

Testing Questionnaire ~

to be completed prior to scheduling
Builder Name*
Person requesting the testing*
Contact telephone number for day of testing:*
Email
example@example.com
If you want anyone else IN YOUR ORGANIZATION copied on emails regarding results or final paperwork, please enter the email address(es) below.
example@example.com
Job Site Address including City where permit was issued:*
Permit Number:*
How will we get in the house? If there is a lockbox, please provide location and lockbox code. If no lockbox....how will we get in? Is there anything else we need to know about getting into the house?*
In the event of rain, is the house accessible without having to walk through mud? Any additional access instructions in the event of rain?
Permanent Power is required for testing. Is permanent power installed?*

YesNo
Preferred Testing Date ~ please note most testing is performed on Thursday & Friday of each week. We try to accommodate requested days but it doesn't always happen.*

Thursday of this weekFriday of this weekThursday of next weekFriday of next week
What type insulation is in the attic?

Foam at the raftersTraditional blown in insulation
What is the tallest ceiling (height) that has A/C registers or returns in it?
Is the house/dwelling unit occupied?*

YesNo
Note regarding occupied structures...if your project is occupied, someone from your organization will need to be present when the testing is performed.
Acknowledgement for occupied structures.*

Confirm
Foundation questions for review......
Is the foundation a slab?

Yes. If yes...skip next sectionNo. If No, complete next section

Pier & Beam Foundation Questions...skip if you answered yes above.

	Yes	No	N/A
Is the foundation Pier & Beam?
If "Yes"...are there ducts under the floor?
Is the grade beam insulated?
Is the grade beam vented?

If "Yes" above....how many HVAC systems have ducts under the floor?
Mechanical questions for review......
How many ducted HVAC systems are in the house/dwelling unit?
Is there a fresh air intake system/HRV or ERV? If yes, which one & how many?
Approximately how many exhaust fans are in the house/dwelling unit?
Please do NOT include ceiling fans in the count of exhaust fans.
Do all the exhaust fans have power and switches?*
Please note: all exhaust fans must be operational....power & switches are required.

Additional Items for Review......please select one option

	Complete & Ready	Not Applicable
Doors must remain closed while testing is performed
All plumbing fixtures installed, water in traps, or drain pipes sealed
Drain on washing machine sealed or machine in place
Attic access doors/hatches in place, weather stripped or sealed
Electrical panel cover on if in conditioned space
Exterior doors & weather stripping in place
Windows installed, no broken panes
No holes in sheetrock
Holes for added outlet boxes installed after sheetrock need to be covered, both walls & ceilings
Dryer vent dampered, vent sealed or dryer installed
Fireplace dampered
Venthood dampered or installed
Outlet covers & switch plate covers installed
If casement windows present, they need to be closed & latched or window crank must be on site

CONSENT & SUBMISSION

By submitting this form I am indicating that I/we are ready for the required testing and that I/my company are liable for all testing fees. Testing fees are due prior to final paperwork being provided.

If testing is requested & scheduled and your project is NOT ready OR if we arrive at your job site on the scheduled testing date and cannot access the house for testing, there will be a trip charge of $200 added to your invoice.

If our inspector has to spend more than 20 minutes determining leaks in order to try to perform the testing, there will be an added charge of $175. These fees are in addition to normal testing fees.

You will be notified by us as to scheduled testing date. We try to get these emails out by Wednesday morning.

Testing fees/quotes are available upon request, prior to testing.

I understand that if re-testing is required, it will be billable.
Please verify that you are human*
Should be Empty:

Testing Questionnaire ~

Note regarding occupied structures...if your project is occupied, someone from your organization will need to be present when the testing is performed.

Foundation questions for review......

Mechanical questions for review......

Please note: all exhaust fans must be operational....power & switches are required.