REQUEST FOR POWER WASH QUOTE
Customer Contact Information
Name
*
First Name
Last Name
E-mail
*
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
General Structure Information
Is this a commercial or residential structure?
*
Commercial
Resdiential
What needs washing?
*
Roof
Siding
Asphalt/Concrete
Deck/Patio
Fences
Windows
Roof
What is the level of infestation?
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)
Which of the following are present on the roof? Choose all that apply.
Lichen
Moss
Algae
Black algae
Other
What is the approximate square footage of the roof?
Roof material?
Steel
Asphalt
Slate
Other
Roof pitch?
Mostly flat and easily walkable (1/12 - 4/12)
Steep, but walkable (5/12 - 8/12)
Very steep, difficult to walk (9/12 - 12/12)
Rust removal needed and level
Yes, light rust is present
Yes, moderate rust is present
Yes, heavy rust is present
No, rust is not present
Roof pictures (if any)
Upload a File
Cancel
of
Siding
What is the level of infestation?
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)
Which of the following are present on the siding? Choose all that apply.
Lichen
Moss
Algae
Black algae
Other
What is the approximate square footage of the siding?
Siding material?
Vinyl
Aluminum
Wood, painted
Wood, unpainted
Stucco
Steel
Other
Rust removal needed and level
Yes, light rust is present
Yes, moderate rust is present
Yes, heavy rust is present
No, rust is not present
Siding pictures (if any)
Upload a File
Cancel
of
Asphalt/Concrete
What is the level of infestation?
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)
Which of the following are present on the asphalt/concrete? Choose all that apply.
Lichen
Moss
Algae
Black algae
Other
What is the approximate square footage of the asphalt/concrete?
Rust removal needed and level
Yes, light rust is present
Yes, moderate rust is present
Yes, heavy rust is present
No, rust is not present
Asphalt/concrete pictures (if any)
Upload a File
Cancel
of
Deck/Patio
What is the level of infestation?
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)
Which of the following are present on the deck/patio? Choose all that apply.
Lichen
Moss
Algae
Black algae
Other
What is the approximate square footage of the deck/patio?
Deck/patio material?
Concrete
Wood, painted
Wood, unpainted
Composite
Brick
Other
Rust removal needed and level
Yes, light rust is present
Yes, moderate rust is present
Yes, heavy rust is present
No, rust is not present
Deck/patio pictures (if any)
Upload a File
Cancel
of
Fences
What is the level of infestation?
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)
Which of the following are present on the fence? Choose all that apply.
Lichen
Moss
Algae
Black algae
Other
What is the approximate square footage of the fence?
Fence material?
Vinyl
Wood, painted
Wood, unpainted
Composite
Brick
Other
Rust removal needed and level
Yes, light rust is present
Yes, moderate rust is present
Yes, heavy rust is present
No, rust is not present
Fence pictures (if any)
Upload a File
Cancel
of
Windows
How many windows are present?
Where are the window screens located?
Inside of the house
Outside of the house
There are no screens
What is the level of infestation?
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 level (we do not remove window rust at this time)
Yes, light rust is present
Yes, moderate rust is present
Yes, heavy rust is present
No, rust is not present
Window pictures (if any)
Upload a File
Cancel
of
Other Information
Other important information.
Other pictures (if any)
Upload a File
Cancel
of
Submit
Print Form
Should be Empty: