New Floor Mount Flagpole

Date of Survey

Time of Survey

Engineer Name

Our Job Number

Company Name

Site Address (if different)

Site Contact (if different)

Name

Contact Number:

Pole Length

Flagpole Material

Base

Finial

Halyard

Cleat

Ground Details

Specify Ground Details

Access

Specify Access

Cherry Picker

Comments

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Photos Attached

Additional Information / Special Requirements

Estimated Time

Men

Day / Night Working

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