Consumer Incident Report

    1

    Personal Information

    2

    Incident Damage Information

    3

    Purchase Information

    Email *

    Your Full Name *

    Your Phone Number *

    Your Address *

    Address of incident if different from your address

    Type of Property *

    Other-Type-of-Property

    Type of Surface *

    Other-type-of-surface

    When was it installed? *

    Was it sealed? *

    When was it sealed?

    Construction *

    Other Construction

    Approximate age of surface (Year) *

    Principal use of surface *

    Other Surface-Use

    How this area has been maintained? *

    Approximate size of surface (sq. ft. / in.) *

    Approximate size of damaged area (sq. ft. / in.) *

    Which product was used? *

    Approximate amount of Safe Paw/Safe Thaw used (lbs)*

    How long after application was problem noticed? (Hours)*

    Weather conditions during usage *

    Other Weather Conditions

    Approximate temperature (°F) *

    Applied to *

    Approximate depth (inches) *

    De-icing history prior *

    Other Deicing History

    What brand(s) did you use before and how long? *

    Submit the photographs of the problem areas *
    In order to ensure completeness of this report, you must submit at least two photographs of the problem area. Please take photos with different perspectives and a ruler or yard stick to help determine area. Please take as detailed and high quality photos as possible to help us properly determine the type and cause of incident.

    Date of Purchase *

    Where did you purchase the product? *

    Other Purchase Location

    Which online platform did you purchase from? *

    Other Online Platform

    Name and Address of Local Store

    Purchase Price *

    Please submit the photographs of the purchase/order receipt *

    Please submit the photographs of the UPC from the product packaging (make sure UPC code is clearly visible) *