REQUEST A QUOTE

ADDITIONAL ADDRESS INFO

HOW SOON IS SERVICE REQUIRED? *

ASAP!- HEALTH DEPT ORDER PENDING!

ASAP!- FIRE MARSHAL ORDER PENDING!

WITHIN 1 WEEK

WITHIN A MONTH

NO RUSH- SHOPPING AROUND

IS THERE A HEALTH DEPT OR FIRE INSPECTOR ORDER/CITATION? *

YES

NO

HEATH INSPECTOR WILL RETURN

FIRE INSPECTOR WILL RETURN

YEARS IN BUSINESS *

LESS THAN 1 YEAR

2-5 YEARS

5-10 YEARS

10+ YEARS

SPECIAL INSTRUCTIONS FOR ROOF ACCESS? *

ADVANCED NOTICE REQUIRED

KEY REQUIRED: ON PREMISES

EXTERIOR LADDER ACCESS ONLY

MALL MANAGEMENT and/or SECURITY MUST BE NOTIFIED

NO SPECIAL ACCESS REQUIRED

AVAILABILITY FOR INSPECTION?

MAIN CONTACT--- CELL NUMBER: *

MAIN CONTACT---NAME & TITLE : *

BILLING NAME & ADDRESS *

STREET ADDRESS: CITY, STATE & ZIP CODE: *

BUSINESS NAME: *

WHEN WAS THE LAST TIME THE KITCHEN EXHAUST HOOD SYSTEMS WERE PROFESSIONALLY CLEANED? *

WITHIN A MONTH

2 MONTHS AGO

3 MONTHS AGO

6 MONTHS AGO

OVER A YEAR AGO

BRAND NEW SYSTEM- NOT CLEANED YET

IT'S BEEN SO LONG, I HAVE NO IDEA

Comments

2ND CONTACT--- EMAIL ADDRESS:

MAIN CONTACT--- EMAIL ADDRESS: *

Upload Photos or Diagram

LOCATION OF EXHAUST FANS *

ROOF MOUNTED

SIDE MOUNTED (side of building)

HOODS: HOW MANY EXHAUST HOODS? *

1

2

3+ (For more than 3 hoods please explain in comments at bottom of page)

TIME OF OPERATION *

2ND CONTACT----- CELL NUMBER: *

2ND CONTACT---NAME & TITLE:

BUSINESS PHONE *

LOCATED IN MALL OR SHOPPING CENTER *

YES

NO

FREE STANDING BUILDING

MALL MGMT OR SECURITY NOTICE? *

YES - NOTIFICATION IS REQUIRED

NOT REQUIRED

NOT SURE (PLEASE CONFIRM BEFOREHAND)