BH Form
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Bilco W1
*
Bilco W2
*
Bilco W3
Bilco L1
*
Bilco L2
*
Bilco L3
Bilco H1
*
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Is there room for a bulkhead raise?
*
Yes
No
N/A
If so, how many inches?
*
Is there a gap against the house?
*
Yes
No
If so, right side measurement of the gap
*
If so, left side measurement of the gap
*
Take a photo of the gap
*
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Siding material?
*
Wood
Vinyl
Cement board
Stucco
Aluminum
Stone
Brick
Siding color?
*
White
Tan
Green
Beige
Yellow
Gray
Brown
Red
Photo of siding material
*
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Height of bulkhead above grade, left side?
*
Height of bulkhead above grade, front side?
*
Height of bulkhead above grade, right side?
*
Take a photo of grade height
*
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Is it a pre-cast bulkhead?
*
Yes
No
Any signs of bulkhead injection needed?
*
Yes
No
If so, is there space at bottom of threshold to inject?
*
Yes
No
If space at bottom of threshold, how many inches?
*
Take a photo of the threshold
*
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If poured in place, are there any cracks?
*
Yes
No
Take a photo of the cracks
*
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Add up to 4 photos
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If so, are they accessible?
*
Yes
No
If not accessible, what needs to be removed?
*
Take photo of the obstruction
*
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Is there block or field stone present?
*
Yes
No
If there's block or field stone, take a photo
*
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Add up to 4 photos
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Door swing?
Right hand in-swing
Left hand in-swing
Door frame rough opening measurements?
Photo(s) of the door
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Add up to 2 photos
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Length of runway?
Height of areawall?
Photo(s) of the stringer area
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Add any additional notes
*
Tech's name
*
Submit
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