Ground Penetrating Radar Checklist

• Project Name:
• Project Location:
• PO #:
• Job #:
• Fax #:
• Job Contact Name:
• Phone:
• Email:
• Company Name:
• Phone:
• Email for Invoicing:
• Billing Address:
• Scanning Completion Date:
• Jobsite hours:
• Thickness of the slab:
• Number of areas to be scanned/scope:
• Building floors (example, 6th and 7th floors):
• Project Manager's Name:
• Project Manager's Email:
• Concrete Type: ElevatedPan DeckPost TensionColumnsSlab on GradeWallsCeilings
• Floor Surface: Raw ConcreteCarpetStone/MarbleLinoleumRoofTitle

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• *** Answer for all the following items: Yes or No

  Question	Answer
  Live conduits or fire alarm in the slab?	YesNoUnknown
  Walker duct in the slab?	YesNoUnknown
  Exterior or outdoor scanning required?	YesNoUnknown
  Hardhats required?	YesNoUnknown
  Lien release needed?	YesNoUnknown
  Is this a certified payroll job?	YesNoUnknown
  Customer or trades examine ceilings below for obstructions prior to technicians arrival?	YesNoUnknown
  Customer understands the capabilities and limitations of this technology?	YesNoUnknown
  Drill spotting required? (If so, additional charges may apply)	YesNoUnknown
  Formal scan report required? (If so, additional charges will apply)	YesNoUnknown
  Vendor Set-up Requirements - Subcontractor agreement, security, or other paperwork needed before work begins?	YesNoUnknown
  Security training or security escorts needed to gain access to site?	YesNoUnknown
  All scan areas are laid out and ready; metal track, drywall, studs, and debris removed; work area clean, prior to technician's arrival? (Additional charges will apply if job site is not ready)	YesNoUnknown
  Any scan locations on tile, mud beds, plywood, wood floors, roof foam insulation or terracotta?	YesNoUnknown
  Is the concrete less than 6 months old (poured)?	YesNoUnknown
  Ceiling scanning required? If so, customer supplied scaffolding/ladder required. (Additional charges will apply)	YesNoUnknown
  Certificate of insurance required before work begins? (If yes, indicate any special text required that must show on this certificate)	YesNoUnknown

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• Contractor/Client Notes:

  1. PVC conduit is difficult and in most cases impossible to view using GPR technology. Pan decks are very difficult to scan, and in most cases impossible to trace metal below the top layer of pan.
  2. GPR cannot be performed on slabs with corrugated metal or recycled concrete.
  3. Our 50/60 Hz Electromagnetic Sensor (EM) only works if conduits in the slab are ‘active,’ with high voltage current running through the circuit. If the current is not ‘flowing’, the sensor will not detect electrical wires. Low voltage can’t be detected with this sensor
  4. Think of alternative locations for cores if scanned areas are not clear
  5. Ceiling scans may necessitate customer supplied scaffolding/lifts and require twice as much time as floor scans.
  6. Verify that penetrations will occur in sections of the slab less than 12 inches deep. Deeper concrete may require X-ray or scanning on both sides of the slab.
  7. Roof penetrations require an area of at least 3 x 3 feet, cleared of gravel and foam. Typically, roof penetrations necessitate additional time and coordination with the general contractor, building engineers, roofers, drillers and other trades people.
  8. A representative from your company should be present to review the results once scanning is complete.
  9. Do not drill within 1 ½” of any marks.
  10. Core hours Monday – Friday 6:00 to 2:00pm. Overtime rates apply after hours and weekends.
  11. PAYMENT IS REQUIRED ON SITE ONCE WORK IS COMPLETE. Credit Card, PayPal or Check accepted.
  12. 24 Business-Hour Cancellation Policy Notice: Customer will be charged if work is cancelled within 24 business-hours of scheduled appointment.
• I acknowledge that I have read all the above Contractor/Client Notes.

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• Release of Liability/Authorization

• In consideration for being able to participate in GPR (Ground Penetrating Radar) scanning of concrete, Releaser, (company name or your name) , for himself, his/her legal representatives, heirs and assigns, releases, waives, and discharges Metro Concrete Scanning Corp., it’s officers, their employees, from all liability to Releaser, legal representatives, heirs and assigns, for any and all loss or damage, and any claim for damages resulting from the use and reliance of GPR data provided or reports presented. Depth of exploration is dependent upon the electrical properties of material(s) inspected and interpretations are opinions based on judgments made from those acquired radar signals and/or other data. Metro Concrete Scanning, therefore, does not guarantee the accuracy or correctness of interpretations.

  Metro Concrete Scanning will not accept liability or responsibility for any loss, damage, or expense that may be incurred or sustained by any services or interpretations performed by Metro Concrete Scanning. GPR scanning cannot distinguish the difference between a single rebar, conduit or post tension cable 100% of the time. It can only detect the center and approximate depth of targets. Releaser assumes full responsibility for the risk of all loss to person or property by using data presented by Metro Concrete Scanning. Releaser further agrees that he has carefully read the forgoing release agreement, knows and understands the contents and signs this release agreement as his own free act. I have read and understand the terms of release of liability and authorization form and agree to be bound by its terms, conditions and disclaimer.

  Because depth of exploration is dependent upon the electrical properties of material(s) inspected and interpretations are opinions based on judgements made from those acquired radar signals and/or other data, Metro Concrete Scanning does not guarantee the accuracy or correctness of interpretations and Metro Concrete Scanning will not accept liability or responsibility for any loss, damage, or expense that may be incurred or sustained by any services or interpretations performed by Metro Concrete Scanning or others. GPR scanning cannot distinguish the difference between a single rebar, conduit or post tension cable 100% of the time. It can only detect the center and approximate depth of targets. This release serves for this job and all future jobs with said company/releaser.

  Releaser agrees that if any portion of this release and waiver agreement is held invalid under the laws of the state MD, VA and/or Washington DC, those parts that are not held invalid shall continue in full legal force and effect.

  Metro Concrete Scanning is not responsible for any loss or damage arising out of the use of, or reliance on the data collected or the report presented.

  If the scanning takes longer because of extended coverage or as a result of the area not being prepared, an additional $168.75 charge will be applied for each additional hour per man/machine. Price $168.75 per hour. Each site visit is a 4-hour minimum of $675.00. Off-hours and weekend work are higher rates. Call for pricing when scheduling. 24 Business-Hour Cancellation Policy Notice: Customer will be charged if work is cancelled within 24 business-hours of scheduled appointment.

  I have read and understand the terms of the release of liability and authorization form and agree to be bound by its terms, conditions and disclaimer.

• Print Name:
• Date:
• Signature:
• Company Name:

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