GPR Form SCHEDULE A SERVICE ONLINE Select the Service You NeedUtility LocatingGPR ScanningMappingConcrete ScanningPotholingCCTV Pipe Inspection Δ Call Now! 1 (866) 638-1075 Name Structure & Surface (GPR) / Concrete Scanning Company Name: * Accounting Email: Company Telephone Number: * Project Name: * Project Address * Name of Person or Company Representative Requesting Quote: * Direct Number * Company Representative's Emali * Job type: Private PW (Public Works) Anticipated target: Rebar Copper Line Steel Line (Steel Conduit) Other: Other Location of surface: Floor Ceiling Ceiling Height? Wall Wall Height? Other: Other: Other Will a lift be needed? Yes No If yes, will you provide? Yes No Will a ladder be needed? Yes No If yes, will you provide? Yes No Note: Util-Locate technicians do no operate lifts, an operator will need to be present at the time of service to assist with the lift. Number of areas: Area dimensions: Thickness: Roberson's decking: Yes No Proposed work by client: Cutting Coring Demolition Other: Other Type of facility: Surface conditions: Smooth Rough Other: Other Surface material: Masonry Concrete Other: Other Area occupied: Yes No Work Area will be cleared for scanning on scheduled day: Yes No Traffic control: Yes No Facility access requirements: Badging (What type?) Will onsite training or orientation be required? Yes No If yes, how many hours? Is jobsite access fee required? Yes No Other: Utility Mapping (Utility Line-Date Collection) required: Yes No Will as-builts, site maps or history of proposed work area be provided? Yes No Terms & Conditions: Util-Locate DOES NOT scan for "Post Tension Cable". Special Instructions Write instructions below:
