FIREPLACEINSPECTION Email Marketing -

Fireman Evaluation Form

Stay updated with the latest fire safety tips, inspection reminders, and expert advice to help keep your home and family protected.

Full Name *

Email *

Phone

Address

City

State/Province

Postal Code

Lintel Gap

Yes

No

Sides Connecting Firebox to Facing Gap

Yes

No

Firebox Walls Contain Cracking, Missing Mortar, and/or Brick Movement

Yes

No

Glazed Creosote

Yes

No

Rust in Firebox or Smoke Chamber

Yes

No

Corbelled Smoke Chamber

Yes

No

Smoke Stains on Facing

Yes

No

Damaged or Non-Functioning Damper

Yes

No

Other Identified Damage