Pullout Test Result Form
Date




The trial fastener installation should be tested in various locations of the roof deck including roof corners and perimeters. Designate the test locations on a roof plan and include with submittals to Carlisle. Refer to the applicable Carlisle Specification for pullout test criteria.

Project Name
Project Location
(City, State)
Authorized Applicator
Submitted By
System Type
Deck Type
Thickness
or Other Specs
Building Height
Warranty Length
Wind Speed Coverage
Fastener Type
Other Fastener Type
Fastener Depth
Fastener Depth (2)
Pullout Results
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Attach Roof Plan

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