Power Washing Assessment

POWER WASH ASSESSMENT
Requested Date of Service

MonthDayYear
Date
Customer Contact Information
Customer Name*

First NameLast Name
Customer Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Customer E-mail*
Customer Phone Number

Area CodePhone Number
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General Structure Information
Is this a commercial or residential structure?*

CommercialResdiential
Roof
Roof that needs washing?*

YesNo
What is the condition of the roof?

1: Very minor or non-existent signs of moss, lichen, algae, etc. (Green)2: Minor signs of moss, lichen, algae, etc. (Yellow)3: Moderate to heavy signs of moss, lichen, algae, and other organic growth (Orange)4: Heavy and excessive signs of moss, lichen, algae, and other organic growth (Red)
Roof material?

SteelAsphaltSlateOther
Rust removal needed and level

Yes, light rust is presentYes, moderate rust is presentYes, heavy rust is presentNo, rust is not present
Roof pictures (if any)

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Siding
Siding that needs washing?*

YesNo
What is the condition of the siding?

1: Very minor or non-existent signs of moss, lichen, algae, etc. (Green)2: Minor signs of moss, lichen, algae, etc. (Yellow)3: Moderate to heavy signs of moss, lichen, algae, and other organic growth (Orange)4: Heavy and excessive signs of moss, lichen, algae, and other organic growth (Red)
Siding material?

VinylAluminumWood, paintedWood, unpaintedStuccoSteelOther
Rust removal needed and level

Yes, light rust is presentYes, moderate rust is presentYes, heavy rust is presentNo, rust is not present
Siding pictures (if any)

Upload a File

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Driveway
Driveway needs washing?*

YesNo
What is the condition of the driveway?

1: Very minor or non-existent signs of moss, lichen, algae, etc. (Green)2: Minor signs of moss, lichen, algae, etc. (Yellow)3: Moderate to heavy signs of moss, lichen, algae, and other organic growth (Orange)4: Heavy and excessive signs of moss, lichen, algae, and other organic growth (Red)
Rust removal needed and level

Yes, light rust is presentYes, moderate rust is presentYes, heavy rust is presentNo, rust is not present
Asphalt/concrete pictures (if any)

Upload a File

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Other Concrete
Other Concrete that needs washing?*

YesNo
What is the condition of the other concrete?

1: Very minor or non-existent signs of moss, lichen, algae, etc. (Green)2: Minor signs of moss, lichen, algae, etc. (Yellow)3: Moderate to heavy signs of moss, lichen, algae, and other organic growth (Orange)4: Heavy and excessive signs of moss, lichen, algae, and other organic growth (Red)
Rust removal needed and level

Yes, light rust is presentYes, moderate rust is presentYes, heavy rust is presentNo, rust is not present
Other concrete information.
Deck/Patio
Deck/patio that needs washing?*

YesNo
What is the condition of the Deck/Patio?

1: Very minor or non-existent signs of moss, lichen, algae, etc. (Green)2: Minor signs of moss, lichen, algae, etc. (Yellow)3: Moderate to heavy signs of moss, lichen, algae, and other organic growth (Orange)4: Heavy and excessive signs of moss, lichen, algae, and other organic growth (Red)
Deck/patio material?

ConcreteWood, paintedWood, unpaintedCompositeBrickOther
Rust removal needed and level

Yes, light rust is presentYes, moderate rust is presentYes, heavy rust is presentNo, rust is not present
Deck/patio pictures (if any)

Upload a File

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Fences
Fence that needs washing?*

YesNo
What is the condition of the fence?

1: Very minor or non-existent signs of moss, lichen, algae, etc. (Green)2: Minor signs of moss, lichen, algae, etc. (Yellow)3: Moderate to heavy signs of moss, lichen, algae, and other organic growth (Orange)4: Heavy and excessive signs of moss, lichen, algae, and other organic growth (Red)
Fence material?

VinylWood, paintedWood, unpaintedCompositeBrickOther
Rust removal needed and level

Yes, light rust is presentYes, moderate rust is presentYes, heavy rust is presentNo, rust is not present
Fence pictures (if any)

Upload a File

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Other Information
Other important information.
Other pictures (if any)

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Should be Empty:

POWER WASH ASSESSMENT

Customer Contact Information

General Structure Information

Roof

Siding

Driveway

Other Concrete

Deck/Patio

Fences

Other Information