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Application for Vaporseal HM Certification
Application for Vaporseal HM Certification
General Information
Date
*
First Name
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Last Name
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Email
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Company Name
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Phone
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Address
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Address
Address Line #1
Address Line #1
Address Line #2
Address Line #2
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Geographic Area of Business
*
Area of Specialty
Company (floor covering contractor, general contractor, coatings application, etc.):
*
Individual (installer, foreman, estimator, owner, etc.):
*
Years in Business / Field
Company:
*
Individual:
*
Related Work Experience
Company
*
Individual
*
Training
Company
*
Individual
*
Has the individual...
Conducted calcium chloride tests
*
Yes
No
If yes, please explain the areas of responsibility.
Applied epoxy coatings?
*
Yes
No
If yes, please explain specific tasks.
Operated surface preparation equipment (shotblast, scabbler, scarifier)?
*
Yes
No
Please list type and details.
What is the knowledge level of concrete?
*
Applied self-leveling materials?
*
Please provide specific areas of responsibility.
*
Does the company routinely...
Conduct calcium chloride tests?
*
Yes
No
Installed epoxy coatings?
*
Yes
No
Own and operate surface preparation equipment?
*
Yes
No
If yes, what type?
Apply self-leveling materials?
*
Yes
No
Has the Individual or Company installed similar waterproofing systems?
*
Yes
No
If Yes, what type?
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