Pull Test Request Please fill out the form below. A member of the DEWALT / Powers Enterprise Solutions Team will review the below information and contact you shortly. (All Fields Are Required.) Due to certain local government and company restrictions surrounding COVID-19, Pull Test requests may be postponed to protect the safety of both parties. Contractor Information First Name Last Name Email Address Company Company Address City State* --Select State*-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist of Columbia Florida Georgia 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 Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Project Information Site Address General Contractor Name Phone Number Email Address Engineer of Record Phone Number Email Address Site Contact Phone Number Email Address Product Information Product Name* --Select Product Name*-- Atomic+ undercut anchors Power-Stud+ SD1 wedge anchors Power-Stud+ SD2 wedge anchors Power-Stud+ SD4/SD6 wedge anchors Power-Bolt+ heavy duty sleeve anchors Screw-Bolt+ screw anchors Snake+ screw anchors Tapper+ screw anchors Hangermate+ rod hanger screw anchors Mini-Undercut+ rod hanger anchors Wood-Knocker II+ form inserts Bang-It+ form inserts DDI+ deck inserts AC200+ adhesive anchors AC100+ Gold adhesive anchors Pure110+ epoxy adhesive anchors Pure50+ epoxy adhesive anchors Diameter Overall Length Embedment Base Material Horizontal*: Yes No Vertical*: Yes No Date of Installation Required Tensile Load to be Tested Point of Purchase Information Distributor Name Phone Number Email Address Date Purchased Agreement Checkboxes I have read and agree to the conditions stated in the disclaimer below*: All anchor and fastener testing is provided as a courtesy. Testing is subject to the availability and capability of the Enterprise Solutions Team (EST). Testing performed by the EST is contingent upon safe conditions at the jobsite. Due to certain local government and company restrictions surrounding COVID-19, Pull Test requests may be postponed to protect the safety of both parties. If the conditions, locations and/or testing environment are determined to be unsafe or hazardous by the EST, testing will be postponed. By selecting this box, I understand and agree to these conditions. Submit Clear
