First + Last Name :*  
                     
                   
 
                    Complete Street Address :*  
                     
                   
 
                    City + ZIP :*  
                     
                   
 
                    Phone number :*  
                     
                   
 
                    Email address :*  
                     
                   
 
                    Referred to us by :*  
                     
                   
 
                    
                     I am   
                    
                    
                    Choose One 
                    the
Agent for the Seller 
                    the
Agent for the Buyer 
                    the
Seller of my current home 
                    the
Buyer of my new home 
                    Refinancing
(Lender requirement) 
                     concerned
about high radon in my home 
                    Other 
                     
                     
                   
 
                    Measured radon level was : 
                       pCi/L, 
                   
 
                     which was measured inside : 
                    
                    
                    Choose One 
                    Basement 
                    1st Floor 
                    Other 
                     
                     
                   
 
                    Service Needed : *  
                    
                    Choose One 
                    Radon
Mitigation of Air in Home. 
                    Radon
Testing of Air in Home. 
                    Adding
a fan to a passive system. 
                    Reducing
radon concentration further. 
                    Interested
in a Super Low
Noise Exterior system. 
                    Test
and
fix if needed before putting my house on the market. 
                    I
want to use Radon H.M.M. again for my new house. 
                    Service/Repair/Fan
Replacement needed. 
                    New Home
Construction RRNC/ App. F or ASTM. 
                    Radon
Testing of Well Water. 
                    Mitigation
of Well Water. 
                    Commercial
Building Radon Consulting. 
                    Radon Flux
Testing before Construction (RRE). 
                    Radon
consult by phone. 
                    Insulation
of Crawl Space Walls. 
                    Mold
Testing. 
                    Electro
Magnetic Field strength Testing. 
                    Physics
related question. 
                    Other 
                     
                     
                   
 
                    Service to be Completed on :*  
                     
                   
 
                    Approx.
Year Built :*  
                     
                   
 
                    Area of Footprint :*  
                    sq.ft.
                     
The "Footprint" is the home's ground contact area or area
viewed from the sky, without garage, with enclosed porch. 
                     
                   
 
                    Shape of Footprint : 
                    
                    
                     
                   
 
                    % of footprint that is
crawl space: *  
                      % 
                     
                   
 
                    % of the basement that is
finished: *  
                      % 
                     
                   
 
                     Is a sump pit in
basement?    
                     Yes  No  
                   
 
                    What type of sump pump is in the pit ? 
                    
                    
                    Choose One 
                    Pit
does not have a sump pump 
                    Submersible
pump type 
                    Pedestal
pump type 
                    Other 
                     
                     
                   
 
                    Roofing material :*  
                    
                    
                    Choose One 
                    Asphalt
Shingles 
                    Wood Shakes 
                    Metal Roof 
                    Concrete
Tiles 
                    Clay Tiles 
                     
                     
                   
 
                    Wall material : 
                    
                    
                    Choose One 
                    Wood Siding 
                    Wood Logs 
                    Real
Bricks  
                    Brick
Veneer 
                    Concrete
Block 
                    Cement
Board siding 
                    Stucco 
                     
                     
                   
 
                    Number of Stories :*  
                     
                   
 
                    Building Style :*  
                    
                    
                    Choose One 
                    Ranch Style 
                    Bi-level 
                    Tri-level 
                    Tri-level
with crawlspace 
                    Tri-level
with Basement = Quad-level 
                    Condominium 
                    2 or
3-story/townhome 
                    French
Colonial 
                    Log Home 
                    Other 
                     
                     
                   
 
                     Is there an enclosed
porch?   
                      Yes  No  
                   
 
                    
                    Number
of posts in crawl space ?  
                    
                       
                   
 
                     Is garage floor at
least 10 inches lower than house floor?
                      
                      Yes  No  
                   
 
                    Heating System :*  
                    
                    
                    Choose One 
                    Furnace 
                    Boiler
w. Hot Water Registers 
                    Boiler
with in-floor heat 
                    Electric
registers 
                    Other 
                     
                     
                   
 
                     
                    
                     
We will try our best to
provide a reliable estimate but ultimately, we will need to
physically
inspect your property to provide the most accurate quote. We may also
contact you for follow-up to get clarification about specific items
that may be necessary to provide a quote.  
                     
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