GENERAL / Date:
Manufacturer:
SUBSTRATE DESCRIPTION /

SAMPLE

/

TYPE

/ ORIENTATION / DESCRIPTION / USE
Brick / Paver / Vertical / Horizontal / Both / Finish / Color / Commercial / Residential
TESTING /

TESTING REQUIRED

BRICK

/ PAVER
Cleaning/Adverse Effects
/
Cleaning/Adverse Effects
Product: / Vana Trol® / Product: / Vana Trol®
600 Detergent / 600 Detergent
Safety Klean / Safety Klean
Other101 Lime Solvent2010 All Surface Cleaner600 DetergentGrout & Tile CleanerSafety KleanSafEtchVana Trol / Other101 Lime Solvent2010 All Surface Cleaner600 DetergentGrout & Tile CleanerSafety KleanSafEtchVana Trol
Water Repellency: List dilution, if appropriate. / Water Repellency: List dilution, if appropriate.
Product: / Siloxane PD / Product: / Paver Enhancer
Siloxane WB Concentrate / Saltguard or Saltguard WB (circle one or both)
Blok-Guard® & Graffiti Control / OtherBG&GCBG&GC IICMSDeep SheenDeep Sheen WBGNGGNG WBNSTNST WBPaver EnhancerSaltguardSaltguard WBSiloxane WB (1:9)Siloxane PDSL100SLX100
OtherBG&GCBG&GC IICMSDeep SheenDeep Sheen WBGNGGNG WBNSTNST WBPaver EnhancerSaltguardSaltguard WBSiloxane WB (1:9)Siloxane PDSL100SLX100
Color Enhancement
Graffiti Repellency / Product: / Paver Enhancer
Product: / Blok-Guard® & Graffiti Control Ultra / Gloss ‘N Guardor Gloss ‘N Guard WB (circle)
Blok-Guard® & Graffiti Control / OtherDeep SheenDeep Sheen WBGNGGNG WBPaver EnhancerSJS
OtherBG&GCBG&GC IICMSSC-1
Stain Repellency
NOTE: This is Page1 of 2 for the Pallet Tag Program submittal form for clay brick. Page2 provides more information on the individual brick types for the lab. / Standard staining agents: Cola, ketchup; mustard, red wine, balsamic vinegar, soy sauce, olive oil, vegetable oil, and hot coffee.
Product: / Stone, Tile & Masonry Protector
SLX100 Water & Oil Repellent (or <350 version)
Additional Information: / OtherDeep SheenDeep Sheen WBGNGGNG WBLMPSLX100STMP
/ RETURN REPORT TO:
Signature Date

Our testing services are offered for all styles of your facing brick and clay pavers. The technical data listed below is critical to determining the proper products to evaluate and the success of our testing program. Please provide a minimum of five brick per style submitted. Allow 6-8 weeks for test results.

Sample Name and/or Number:
Percent Fire Clay
Percent of Grog
ASTM C 62 Grade
(SW, MW)
ASTM C 67 Initial Rate of Absorption
Vertical or Horizontal
% Metallic Components:
Manganese
Chromate
Vanadium
Iron
Slip or Finish:
(sand, slurry, wire-cut, engobe, bark-face, standard velour, etc.)