local: 763-422-0481
outstate: 1-800-CHIMNEY
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Your Name (required)
Phone (H)
Phone (C)
Address
City
State
Zip
Country
Email (required)
Sale of Home?
no
yes
Preferred Week
AM or PM?
AM
PM
Have we been to this house before?
Yes
No
Type of house:
Rambler
Split
2-Story
Other
Fireplace
Wood Stove
Furnace
If a wood stove:
Freestanding
Front of Fireplace
Inside of Fireplace
Number of Fireplaces:
0
1
2
3
4
5
6
7
8
9
10
Is the chimney above the roof line brick?
Yes
No
Do you have a Top-Mounted Damper (TMD)?
Yes
No
Is there any kind of heat-producing unit or Insert in the fireplace?
Yes
No
Heatalator
Insert
w/ liner
Is the roof steep or difficult to walk on?
Yes
No
Roof Type
Shingles
Cedar
Tile
Slate
Chimney Location
Outside Wall
Interior Wall
Concerns or Frustrations
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