4456 S. Clifton, Wichita, KS 67216
(316) 522-9300/(800) 676-7346
stacy@watersealant.com
10 Year Vertical Water Repellent/5 Year Graffiti Protection Combo Warranty Application (Section 3)
To be completed upon project completion
Project Name:
City:
State:
Project Detail:
Was the entire project, listed in Section 1, treated?
Yes
No
If no, Describe the specific areas that weren't treated with Professional Water Sealant:
Application Information:
PWS Strength Used and Number of Gallons Used: PWS-15 (Super) or PWS-8 (Extra)
Product Batch #(s) (located on stick on label on product container)
Square Footage of Area Treated for Graffiti Protection (2 Coats):
Square Footage of Area Treated for Water Repellent Protection (Area with 1 Coat Only):
Total Project Square Footage Treated:
Actual Coverage Rate for 1st Coat (divide the number of sq ft treated by the number of gallons used):
sq ft/gal
Actual Coverage Rate for 2nd Coat (divide the number of sq ft treated by the number of gallons used):
sq ft/gal
Application Date(s):
-
Month
-
Day
Year
Date
Application Method:
Weather Conditions:
Distributor Name:
Distributor Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
After Application Testing
To be done 10-14 days after project completion
Testing Completed By:
Company Name
Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Date of Rilem Testing:
-
Month
-
Day
Year
Date
Type of Rilem Used - Tall or Short (Short for Block Only):
Test Results: Did the water level on the Rilem tube drop no more than 20% after 20 minutes
Yes
No
Project Manager Certification:
I certify that the information provided on this application is correct and that the product was applied in accordance with Professional Products of Kansas' Application Instructions.
Project Manager:
First Name
Last Name
Signature
Form Submission
Submitted By:
First Name
Last Name
Submitted On:
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Product purchase invoices must be submitted with this application
Attach here or email any additional info or questions to Stacy@watersealant.com
Purchase Invoices (or any additional added information)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Continue
Continue
Should be Empty: