Concrete Evaluation Form

Consultant Name

Client Name

Total Sq. Ft.

Approximate Age of Concrete

Pitting (Est. Total Sq Ft)

Hollow Spots (Est. Total Sq Ft)

Chipping/Flaking (Total Sq. Ft.)

Cracks (Total Linear Ft.)

Height/Depth of Heaving/Settling (Total Inches)

Moisture Content

If Yes What Type of Coating

Overview Photos

Upload photos showing the overall concrete area (max 5MB)

For multiple photos or if your file is over 5MB, please upload to a service like Google Drive and share the link below

Damage/Issue Photos

Upload photos showing specific damage or issues (max 5MB)

For multiple photos or if your file is over 5MB, please upload to a service like Google Drive and share the link below

Additional Notes

Basic Information