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New construction, planning stage
Preventive on existing structure
Problem solving on existing structure
Stop or prevent water and moisture to travel through concrete capillaries
Repair cracks in concrete
Stop water infiltration through cracks
Repair damaged concrete
Protect concrete against elements
Protect concrete against attack of corrosive chemicals
Protect steel or other substrate against attack of corrosive chemicals
  
Concrete (To be poured later)
     
 

Existing:

Age of concrete:

 
  

Thickness:

  
  

Crack length:

  
     
   

Crack width

 
 

Average:

  
  

Minimum:

  
  

Maximum:

  
   

 

Is concrete painted or covered

 Yes   No
  
  
OTHER SUBSTRATE 
  
Concrete blocks 
Concrete bricks 
Clay bricks 
  
Other: specify  
 
 
 
  
Accessibility Exterior
Interior
Both
  
Water infiltration Crack
Joint
Hole
Overall sweat
Occasional
Steady
  
Structural concern Is structure subject to movement Yes   No
Is reinforcement exposed Yes   No
 
Structure is Above ground
Underground
Underwater
  
Is aesthetic a concernYes   No 
  
When is work scheduled?  
   

Describe project and additional details:

  
 
 
 
   
   
General informations   
   
Name 
Title 
Company  
Telephone  
Fax  
E-mail 
  
  
  
  Please allow about 24-48 hours for an answer.