No-Burn Product Application Certificate "*" indicates required fields Step 1 of 8 12% Company* Name* Email Address* Phone*Applicator Number* If you do not have an Applicator ID, please contact No-Burn, Inc. at (800) 989-8577. Project InformationBuilder/Owner Community Address City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZip Project ID/Lot Number Describe Area TreatedDescribe the Substrates and Areas Treated*Moisture Meter Reading (%)* Temperature (°F)* Basement Footprint Square Feet* Product Applied*No-Burn® PlusNo-Burn® Plus XDNo-Burn® Plus MihNo-Burn® OriginalNo-Burn® Original MihNo-Burn® Wood GardNo-Burn® Wood Gard MihSubstrate*I-Joists and subfloorI-Joists, subfloor and rim boardDouglas FirRed OakOriented Strand BoardPlywoodSouthern Yellow PineBASF Enertite® USBASF Spraylite® 178BASF Walltite® USBASF Walltite® US-NBASF Comfort® Foam 178Icynene MD-C-200™Laminated Strand Lumber (LSL)Laminated Veneer Lumber (LVL)OTHERSubstrate*BASF Enertite® NMBayer Bayseal™Convenience Touch 'n Seal®Demilec Sealection® 500Demilec Sealection Agribalance®FOMO Handi-Foam® E-84Huber ZIP System® R-SheathingIcynene Classic (LD-C-50TM)Icynene Classic Eco (LD-R-50TM)Icynene MD-R-200Icynene Classic Plus (LD-C-70TM)Tiger Foam Insulation E-84OTHERSubstrate*Douglas FirOTHERSubstrate*Douglas FirOriented Strand BoardPlywoodOTHERSubstrate*Southern Yellow PineOTHERSubstrate*Douglas FirOTHERSubstrate*Douglas FirOriented Strand BoardPlywoodOTHEROther Substrate I-Joist Manufacturer* Examples: International Beams Inc., Nordic Engineered Wood, Georgia-Pacific Wood Products, LLC, etc.I-Joist Series* Examples: IB-400, AJS-5, WI 40, RFPI-40S, BCI 4500s 1.8, etc.I-Joist Depth* 9 1/2″, 11 7/8″, 14, 16, etc.I-Joist On Center (OC) Spacing*16 Inches on Center19.2 Inches on Center24 Inches on CenterWet Mils* Total Gallons Used* Date of Application* MM slash DD slash YYYY Describe Any Additional Substrates, Areas Treated or Exclusions Certified Applicator Certified Applicator Email Additional Emails Separate additional emails with a comma. Substrate prior to the application of No-Burn® Take pictures of substrate(s) prior to the application of No-Burn®. (e.g. for first floor framing: subfloor and I-joist) Where substrate identification is visible, pictures must be taken prior to the application of No-Burn®. (e.g. for first floor framing: subfloor and I-joist with manufacturer stamp on each) A minimum of three pictures must be taken of the untreated substrate and submitted with this form.Picture Upload Drop files here or Select files Max. file size: 256 MB. Substrate with the application of No-Burn® Take pictures of the substrate(s) after the No-Burn® product has been applied. (e.g. for first floor framing: subfloor and I-joist) Appropriate wet film thickness of the No-Burn® product must be measured (e.g. using a wet film thickness gauge) and confirmed prior to taking pictures of the treated substrate. A minimum of three pictures must be taken of the treated substrate and submitted with this form.Picture Upload Drop files here or Select files Max. file size: 256 MB. Signature Or upload a signature imageMax. file size: 256 MB. PhoneThis field is for validation purposes and should be left unchanged.
