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UNIVERSAL <br />ENGINEERING SCIENCES <br />Grounded in Excellence <br />Geotechnical Engineering <br />Construction Materials Testing & Inspection <br />Building Code Compliance <br />Occupational Health & Safety <br />Environmental <br />Building Envelope <br />REPORT DISTRIBUTION INFORMATION REQUEST FORM <br />Date UES Project # <br />Attention <br />Project <br />Fax # <br />Permit # <br />The following Names, Addresses and Permit Numbers need to be supplied in order to assist in the distribution of reports for your <br />project. Your cooperation in quickly responding will assure no delay in the completion of your construction operations and the <br />distribution of all your reports. <br />Note: Reports will be distributed electronically. Hard copies of reports can be provided upon request and will be billed at $75 <br />per physical copy. Hard copies of Blower Door Testing reports will not be distributed unless specifically requested. A field report <br />will be provided upon completion of the test. <br />CLIENT INFORMATION <br />Attention: <br />Address: <br />City: State: Zip: <br />Phone #: <br />Please Choose From the Following Options <br />FlElectronic Copy (via email) <br />Email: <br />GENERAL CONTRACTOR <br />Attention: <br />Address: <br />City: State: Zip: <br />Phone #: <br />Please Choose From the Following Options <br />Electronic Copy (via email) <br />Email: <br />ARCHITECT OF RECORD <br />Attention: <br />Address: <br />City: State: Zip: <br />Phone #: <br />Please Choose From the Following Options <br />F]Electronic Copy (via email) <br />Email: <br />BUILDING DEPARTMENT <br />Attention: <br />Address: <br />City: State: Zip: <br />Phone #: <br />Please Choose From the Following Options <br />❑ Electronic Copy (via email) <br />Email: <br />ENGINEER OF RECORD <br />Attention.- <br />Address: <br />ttention:Address: <br />City: State: Zip: <br />Phone #: <br />Please Choose From the Following Options <br />F]Electronic Copy (via email) <br />Email: <br />OTHER <br />Attention: <br />Address: <br />City: State: Zip: <br />Phone #: <br />Please Choose From the Following Options <br />F]Electronic Copy (via email) <br />Email: <br />Please remit completed form to your local Team UES Representative. <br />©2020 Universal Engineering Sciences, LLC All Rights Reserved. SAL -000028R4 <br />