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Alabama
Birmingham, AL
Dothan, AL
Huntsville, AL
Mobile, AL
Arizona
Phoenix, AZ
Phoenix, AZ (EAI)
Phoenix, AZ (PNL)
California
Anaheim, CA
Los Angeles, CA
Pleasanton, CA
Oakland, CA (ARCCA)
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San Diego, CA
Temecula, CA
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Colorado Springs, CO (Empirical)
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Denver, CO (ITC)
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Florida
Hollywood, FL
Jacksonville, FL
Pensacola, FL (McSwain)
Pensacola, FL (Veracity)
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Alpharetta, GA
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Suspended Access/Fall Protection Questionnaire
Applied Technical Services (ATS)
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Suspended Access/Fall Protection Questionnaire
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Applied Technical Services (ATS)
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Suspended Access/Fall Protection Questionnaire
Step
1
of
2
50%
Building Address and Contact Information
Building Name
Building Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Property Manager Name
(Required)
First
Last
Property Manager Phone Number
(Required)
Property Manager Email
(Required)
Building Engineer Name
First
Last
Building Engineer Phone Number
Building Engineer Email
Building-Specific Information
Date of Construction
Year
How tall is the building?
Building Height
Number of Floors
Building Height
Give units (i.e., feet or meters)
Number of Floors
Total Number of Roof Levels
Total Number of Balconies
Total number of atriums with fall protection requirements
Roof Framing Type
Concrete
Steel Frame
Wood
Other
What "other" roof framing type?
Type of Roof System
TPO
PVC
EPDM
Modified Bitumen
Other
What "other" type of roof system?
Are roof areas and/or balconies provided with 42" high parapet walls or guardrail?
Yes
No
Types of Equipment
Do you have existing suspended access or fall protection equipment on the building?
No Equipment
Roof Anchors
Davit Bases
Portable Davit Arms and Sockets
Portable Outriggers
Structural Equipment (Steel Beams, Screen Wall Columns, etc.)
Monorails
Building Maintenance Unit (BMU)
Horizontal Lifelines
Other
Is any previous documentation available?
Yes
No
Roof Anchor qty
Davit Base qty
Portable Davit Arm qty
Has the existing equipment on the building been load tested/certified?
Yes
No
Date of Last Test/Certification
Month
Day
Year
Has the existing equipment on the building been annually inspected?
Yes
No
Date of Last Annual Inspection
Month
Day
Year
Describe any type of known problems or concerns with the existing rooftop safety equipment
Building Documentation
Are structural drawings available?
Yes (PDFs)
Yes (Hard Copies)
No
Do you have equipment documentation?
Most recent inspection
Latest test/certification
Installation
Where applicable, please send previous reports, equipment photographs, and drawings to:
[email protected]
Do you have a lightning protection system?
Yes
No
Do you have a parking deck?
Yes
No
Maintenance Requirements
How are façade and windows currently accessed?
Rope Descent System
Suspended Scaffold
Other
What "other" method of cleaning?
What is the preferred method of access?
Rope Descent System
Suspended Scaffold
Other
What "other" method of cleaning?
Who is your current window washing vendor?
Is there any other routine exterior maintenance requiring rooftop safety equipment?
Yes
No
Are there any projected exterior projects in the next five years (e.g., caulking, wet sealing, window replacement, etc.)?
Yes
No
Phone
This field is for validation purposes and should be left unchanged.