Request Inspection ServiceSelect ServiceHome InspectionMold AssessmentIndoor Air Quality TestingRequest 203(K)/Rehab/Renovation ConsultantAsbestos Testing and InspectionRequest Home InspectionRequest Mold AssessmentRequest Indoor Air Quality TestingRequest 203(K)/Rehab/Renovation ConsultantAsbestos Testing and InspectionPersonal InformationName First Last CompanyIf the request is by a company. Email Phone Address (Location of Inspection)All buildings are unique, providing the location of inspection will help us pre-research the property so we can be prepared for the inspection.Address Street Address City ZIP Code Inspection DetailsDeadlineLast date inspection can be performed. MM slash DD slash YYYY Services Required FHA 203(k) Consulting with Work Write-Up Draw Request Inspections Initial Consultation/Budget Study Home Inspection Services Required General Inspection Radon in Air (IF NO, PLEASE VERIFY WITH AGENT) Radon in Well Water (Tests for radon concentrations in well water supply) Wood Destroying Insects (Conventional/Standard) Lead Paint (2 Swabs) Well Yield Water Quality Test (Conventional/Standard – Total Coliform, E.Coli) Water Quality Test (FHA Short – Total Coliform, E.Coli, Nitrate, Nitrite, Lead) BE ADVISED: Lead water testing can delay all water test results up to (21) days. Water Quality Test (FHA/HUD-Long – Total Coliform, E.Coli, Nitrate, Nitrite, Lead, Iron, Manganese, Sodium, pH, Hardness, Turbidity and Alkalinity) BE ADVISED: Lead water testing can delay all water test results up to (21) days. Septic Inspection (Includes full pump-out with digital camera of system from certified and licensed third party inspector) Indoor Air Quality (Hidden Mold and Other Contaminants) Drone Inspection (High roof inspection, includes 8K high res aerial shot of property, added fee) Services RequiredAn asbestos survey is to be utilized for asbestos remediation and will be required where asbestos remediation and/or removal is required. Bulk sampling of asbestos only and is not the same as an Asbestos Survey. If at any time the results of bulk sampling leads to asbestos remediation of any type the CLIENT understands that the scope of that service will need to be converted to an “Asbestos Survey”. Asbestos Survey (Provide sampling, lab analysis and report, for projects requiring asbestos remediation) Bulk Sampling Only (Provide sampling and lab analysis only, for those who want to know if asbestos exists, but may not require removal.) Does a full home or structure require inspection? Yes No Materials to be Sampled Per Client:Enter materials here. Please be specific and try to identify approximate amount of material that exists in the description box further below… Description of Materials and Approximate Square FootagePlease describe each material, location and approx. square footage.Services Required Mold Assessment (Level 1 – Visual inspection utilizing infrared, moisture detection devices and borescope as necessary of client defined areas) HVAC Duct Screening (Level 2 – Identify presence of moldy ductwork and/or the need for duct cleaning) Swab Sampling (Level 2 – Identify and confirm the presence of mold at suspicious locations) Indoor Air Quality Testing – Mold (Level 3 – Mold only) Indoor Air Quality Testing – Mold/With Other Particles (Level 3 – With other particles to identify other organic particles/allergens, adds additional fee) Full Home Comprehensive (Couples a level 1, 2 and 3 service together at a discounted price to provide a full mold and building hygiene assessment of the entire property, highest service level) Clearance Inspection (Come back after remediation services are completed) Sewage Backup Assessment Services Required Indoor Air Quality Testing – Mold Indoor Air Quality Testing – Mold/With Other Particles (Other particles identifies other organic particles/allergens, adds additional fee) Radon in Air Radon in Well Water (Tests for radon concentrations in well water supply) Volatile Organic Compounds (VOCs) Formaldehyde Metals Tobacco Smoke Client Defined Areas Attic Basement Finished Basement Crawlspace 1st Floor 2nd Floor 3rd Floor Ductwork Other Area Description of ProblemPlease describe the problem and how it was discovered.Water IntrusionIs there water intrusion in the building? Yes No Unsure N/A Moisture CorrectedHave all sources of moisture been corrected? Yes No Unsure N/A Water DamageAre there water damaged building materials in the building? Yes No Unsure N/A Visible MoldIs there visible mold growth? Yes No Unsure OdorAre there musty/moldy odors in the building? Yes No Unsure HealthHave any occupants experienced any adverse health effects? Who's AffectedWho has the symptoms? SymptomsWhat are the symptoms? Occupancy Occupied Unoccupied Unsure If you require a Home Inspection, please fill out the Home Inspection Form as wellLoan Type FHA 230(k) Streamlined FHA 230(k) Standard SONYMA Other Estimated/Confirmed Rehab Amount Home CharacteristicsPlease include as many details as you can and we will respond with a comprehensive quote as soon as possible. If you are unsure, it is okay, we are here to help you every step of the way.Square Footage <1000 1000-2000 2000-3000 >3000 Unsure Type Single Family Two Family (Shared Utilities) Condo Townhouse Multiple Unit Apartment Mobile Home/Trailer Commercial Unsure Number of UnitsUtilitiesAre the utilities shared between units or separated? Shared Separate Basement Type Full Basement Full Finished Basement Slab Crawlspace None Unsure Sanitary Type Sewer Septic Seepage Pit Unsure Water Source Private Well Public Unsure Garage Type Attached Detached None Unsure Number of BathroomsNumber of KitchensNumber of FireplacesAir Conditioning Yes No Year AgentPlease insert your real-estate agents name and phone number. Additional InformationFHA 203(k) Consultant Application FormPlease complete the following information if requesting FHA 203(k) Consulting services.Lender Name Loan Number Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Loan Officer Name First Last Loan Officer PhoneLoan Officer Email Address Borrowers Current Mailing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Date FHA Work Write-Up Required MM slash DD slash YYYY How Did You Find Us?Please, tell us how you found us! CommentsThis field is for validation purposes and should be left unchanged. 71522