Date
Contractor
Email Address
Installer
Installer Certification #
Apprentice
Apprentice Certification #
Project Name
Street Address
City
Province
Customer Name
Manufacturer
Product
Material CCMC #
Lot # - A Component
Lot # - B Component
Expiry Date - A Component
Expiry Date - B Component
Quantity of foam used (today)
Mixing Chamber Size
Hose Length
Heater Temerature (°C)
Hose Temerature (°C)
Pressure - A Side
Pressure - B Side
Time
Ambient Temp (°C)
Relative Humidity
Wind Velocity (km/h)
Substrate Temp (°C)
Manufacturer's Minimum Required Density kg/m3 lb/ft3
Weight of Sample (g)
Volume Displaced (ml)
Calculated Density kg/m3 lb/ft3
Number of Passes
Thickness per Pass (mm)
Total Foam Thickness (mm)
Adhesion Test --- Pass Fail
Cohesion Test --- Pass Fail
Substrate Type
Was The Substrate Clean --- Yes No
Was The Substrate Dry --- Yes No
Properly Fastened / Proper Adhesion --- Yes No
Primer Required --- Yes No
If Yes Provide Details
Protective Coating Required: --- Yes No
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