Glass Heritage | Fully accredited studio with Stained Glass Association of America

Condition Questionaire Form

Items marked * are required fields

Name of Church:

Contact Name: *

Email: *

Address:

City:

State:

Zip:

Daytime Phone:

Title:

		YES	NO	Maybe?
1.	Do you have Protective Covering?:

	if yes, then:
A.	Are any of the existing protective coverings leaking, broken or discolored?:
B.	Is Existing protective covering vented?:
C.	Do frames need repair or painting?:
D.	Is there any signs of water on the inside of the still, sash or protective covering?:
2.	Is there any loose or missing putty arond teh exteriro frame?:
3.	Are there any light leaks around the glass or sash?:
4.	Are there any obvious gaps between glass and lead?:
5.	Can you see sections of the window that bulge in or out?:
6.	Are any of the steel reinforcing bars loose, falling, have broken ties or are detached in any way or missing?:
7.	Can you see any broken or cracked glass?:
8.	Can you notice any flaking or fading glass painting in your stained glass window?:
9.	Is there a dark film developing around the lead?:
10.	Do your windows appear dingy and loosing their appeal?:
11.	Have your windows been noticeably repaired before?:

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CONTACT

Glass Heritage, LLC
3113 Hickory Grove Rd
Davenport, IA 52806

Phone: 1.563.324.4300
Toll Free: 1.877.324.4300
Phone: 1.309.322.0944
Fax: 1.563.324.4321

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