Coating Questionaire

Concrete Coating Job Site Questionaire

Please complete fields below to receive a custom coating quote.
Call our technical department @ 901-820-0007 with any questions. Thank you.

Information about you:
Company:
Your Name: *
Address:
City / State / ZIP:
Cell Phone: *
Email: *
STAUF Representative:

Information about the jobsite:
Contractor Name:
Jobsite Name:
Jobsite Address:
Jobsite City, State, ZIP: *
Current Floor Coating: *
Intended Use of Floor: *

Accessability:
Loading Dock available:	Yes No
Floor is in climate controlled room:	Yes No
Fork Lift available:	Yes No
Number of 110V Outlets:
Number of 220V outlets:
Total square Footage:

System and Components:
Select System:
Select Grinding:
Select Priming:
Select Leveling:
Select Base Color:	Color Choices
Select Roll Coat (Garage/Warehouse only):
Select Flake/Quartz Color:	Flakes Choices
Select Flake/Quartz Density:	Flakes Densities
Select Top Coat:
Select Anti-Slip:

Additional areas to be covered:
Coating on Wall:	Yes No
Height (inch):
Width (feet):
Baseboard Height:
Baseboards (feet):
Cover Stairs:	Yes No
Number of Stairs:
Width of Stairs:

Additional jobsite conditions:
Vehicular Traffic (cars, forklift):	Yes No
Sunlight exposed (includes indirect):	Yes No
Width of transitions (LF):
Width of separation between pour (LF):
Length of spider cracks (LF):
Length of dynamic joints (LF):
Width of dynamic joints (in):
Area of spalling/broken surface (SF):
Average depth of patch required (in):
Area of contaminated surface (SF):
Installation of vinyl logos (SF):

A little math: what is four plus four? *	(This is to verify human input, not a robot.)