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			<td colspan="3" style="text-align: left; vertical-align: middle; width: 40%;"><span class="titre_p" style="font-family:ITCAvantGardePro;font-size:18px;font-weight:900;">DOSSIER DE DIAGNOSTIC TECHNIQUE</span></td>
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			<td style="text-align: left; vertical-align: middle; width: 40%;">{% checkbox_tag name=&quot;02faaf70&quot; data_label=&quot;Etat amiante&quot; data_map_field=&quot;nomap&quot; data_help=&quot;&eacute;tat amiante&quot; data_ancien_ids=&quot;2084,13094,8713,8417,9133,6903&quot; %}<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&nbsp;&eacute;tat amiante</span></td>
			<td style="text-align: left; vertical-align: middle; width: 40%;">{% checkbox_tag name=&quot;3ab7b4db&quot; data_label=&quot;Constat de risque d&#39;exposition au plomb&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Constat de risque d&#39;exposition au plomb&quot; data_ancien_ids=&quot;2106,13141,8760,8486,9181,6927&quot; %}<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&nbsp;constat de risque d&rsquo;exposition au plomb</span></td>
			<td style="text-align: left; vertical-align: middle; width: 20%;">{% checkbox_tag name=&quot;48222e47&quot; data_label=&quot;Etat parasitaire&quot; data_map_field=&quot;nomap&quot; data_help=&quot;&eacute;tat parasitaire&quot; data_ancien_ids=&quot;2197,13283,8902,8578,9324,6805&quot; %}<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"> &eacute;tat parasitaire</span></td>
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			<td style="text-align: left; vertical-align: middle; width: 40%;">{% checkbox_tag name=&quot;cfb78684&quot; data_label=&quot;Etat de l&rsquo;installation int&eacute;rieure d&rsquo;&eacute;lectricit&eacute; &quot; data_map_field=&quot;nomap&quot; data_help=&quot;&eacute;tat de l&rsquo;installation int&eacute;rieure d&rsquo;&eacute;lectricit&eacute; &quot; data_ancien_ids=&quot;2220,13378,8996,8601,9419,7025&quot; %}<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&nbsp;&eacute;tat de l&rsquo;installation int&eacute;rieure d&rsquo;&eacute;lectricit&eacute;&nbsp;</span></td>
			<td style="text-align: left; vertical-align: middle; width: 40%;">{% checkbox_tag name=&quot;c9890a51&quot; data_label=&quot;Diagnostic performance &eacute;nerg&eacute;tique &quot; data_map_field=&quot;nomap&quot; data_help=&quot;diagnostic performance &eacute;nerg&eacute;tique &quot; data_ancien_ids=&quot;2131,13189,8808,8509,9230,6757&quot; %}<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"> diagnostic performance &eacute;nerg&eacute;tique</span></td>
			<td style="text-align: left; vertical-align: middle; width: 20%;">{% checkbox_tag name=&quot;ab47f68e&quot; data_label=&quot;diagnostic Bruit&quot; data_map_field=&quot;nomap&quot; data_help=&quot;document informatif sur les risques de nuisances sonores a&eacute;riennes&quot; %}<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&nbsp;diagnostic Bruit</span></td>
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			<td style="text-align: left; vertical-align: middle; width: 40%;">{% checkbox_tag name=&quot;ee0deab3&quot; data_label=&quot;Etat des risques&quot; data_map_field=&quot;nomap&quot; data_help=&quot;ERRIAL&quot; %}<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&nbsp;&eacute;tat des risques</span></td>
			<td style="text-align: left; vertical-align: middle; width: 40%;">{% checkbox_tag name=&quot;617c2c09&quot; data_label=&quot;Etat d&#39;installation de gaz&quot; data_map_field=&quot;nomap&quot; data_help=&quot;installation gaz&quot; data_ancien_ids=&quot;2153,13355,8973,8532,9396,7001&quot; %}<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"> &eacute;tat de l&rsquo;installation int&eacute;rieure de gaz</span></td>
			<td style="text-align: left; vertical-align: middle; width: 20%;">&nbsp;</td>
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			<td style="text-align: left; vertical-align: middle; width: 40%;">{% checkbox_tag name=&quot;0d3b13e6&quot; data_label=&quot;Contr&ocirc;le d&#39;assainissement collectif ou non collectif&quot; data_map_field=&quot;nomap&quot; data_help=&quot;contr&ocirc;le assainissement collectif ou non collectif&quot; %}<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&nbsp;contr&ocirc;le assainissement collectif ou non collectif</span>&nbsp;</td>
			<td style="text-align: left; vertical-align: middle; width: 40%;">{% checkbox_tag name=&quot;69373b85&quot; data_label=&quot;Bornage&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Bornage&quot; data_ancien_ids=&quot;5090,13427,9043,8440,9466,6659&quot; %}<span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&nbsp;bornage</span></td>
			<td style="text-align: left; vertical-align: middle; width: 20%;">&nbsp;</td>
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			<td style="vertical-align: top; width: 3%;">{% checkbox_tag name=&quot;8b630838&quot; data_label=&quot;Autres Diagnostics&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Autre DDT&quot; data_ancien_ids=&quot;5114,13498,9115,8671,9538,6610&quot; %}</td>
			<td style="width: 97%;">{% textarea_tag name=&quot;4acd9b54&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;D&eacute;signation des autres diagnostics&quot; data_map_field=&quot;nomap&quot; data_help=&quot;D&eacute;signation des autres diagnostics&quot; data_ancien_ids=&quot;5166,13521,9138,8348,7984,7961,9561,6634&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}&nbsp;</td>
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