form_title=Water Damage Repair form_header=8163 Give how big the
area is that is affected?*= () Small area indoors () One room ()
Several rooms () Small area outdoors () Large area outdoors ()
Other () Don't Know Please indicate the signs of damage. (Choose
all that apply)*= [] "Currently damp or wet [] Soft, rotten or
powdery surfaces [] Moldy appearance or odor [] Water stains or
discoloration [] Buckled wood or wallboard [] Peeling paint []
Evidence of insects [] Other" Please indicate any materials that
are damaged? (Select all that apply)*= [] Wallboard [] Vinyl
Flooring [] Hardwood floor [] Wood sub-floor [] Tile or grout []
Cabinetry or wood trim [] Wood framing materials [] Insulation []
Exterior wood [] Stucco [] Other What are the possible causes of
the water damage? (Select all that apply)*= [] Toilet overflow []
Pipe burst [] Fire sprinkler went off [] Sink overflow [] Washing
machine hose [] Drain back-up [] Roof leak [] Slow or gradual leak
or water exposure [] Other [] Don't Know When did you sense the
problem first?*= () Just noticed () Discovered during inspection ()
Several months () More than a year () Other Please make a selection
for the location of the damage*= [] "Interior rooms [] Bathroom or
kitchen [] Window sills/trim [] Flooring [] Ceiling [] Walls []
Attic [] Basement or under crawl space [] Exterior of house
(siding, trim, eaves) [] Roofing [] Deck, porch or other structure
[] Wooden fencing or retaining wall [] Other"