SEPTIC SYSTEM INSPECTION ORDER FORM
* Required Fields

NOTE:  PAYMENT NEEDS TO BE ARRANGED PRIOR TO INSPECTION.
NO REPORT WILL BE ISSUED UNTIL PAYMENT IS RECEIVED.

* Requester's Name
*Requester's Phone
Settlement Date
Property Address
Municipality County
Block Lot

Seller's Information
* Seller's Name
Street Address
Post Office
City State   Zip 
*Home Phone Work Phone
Cell Phone Fax
No. of Adults Number of Children
No. of Bedrooms Age of Home
Well Water?

Buyer's Information
* Buyer's Name
Street Address
Post Office
City State   Zip 
*Home Phone Work Phone
Cell Phone Fax
No. of Adults Number of Children
Pumping Inspection
Is this a Re-Inspection?

Seller's Realtor Information
Seller's Agent
Seller's Agency Name
Street Address
Post Office
City State   Zip 
Agent's Email
Office Phone Office Fax
Home Phone Home Fax
Cell Phone

Buyer's Realtor Information
Buyer's Agent
Buyer's Agency Name
Street Address
Post Office
City State   Zip 
Agent's Email
Office Phone Office Fax
Home Phone Home Fax
Cell Phone
Verify

Service Agreement

By requesting the inspection services, I understand that the nature, location and system condition cannot be determined prior to completion of the field inspection and technical review of the data collected.

I understand that a normal part of the inspection process involves the use of a non-metallic probe to penetrate the earth in search of buried tanks and system components.  It also involves opening the tanks for inspection and auguring the drain field.  If not pumped at the time of inspection, it will not be possible to determine the true condition of those tanks.  It is sometimes necessary to position the service truck on the property to pump the tanks for internal inspections or incur the use of a backhoe to open tanks greater than 12" in depth.  Involvement of a backhoe will incur additional fees and labor.

I acknowledge that the inspection process can result in damage to unmarked or buried utilities such as sprinkler systems, wiring, water lines, gas lines, fuel lines, fuel storage tanks, paved driveways, lawns, etc. during tank location and access.  If necessary to cross any unpaved areas of the yard, English Inspection Services, Inc.  is not responsible for ruts resulting from such passage and release English Inspection Services, Inc., its employees and officers from any claim of property damage resulting from that crossing.

I represent and warrant that I am the owner or the duly authorized agent of the owner(s) of the premises, that I am of legal age and can contract in my own name.  In the event my account is referred to a collection agency or attorney for non-payment of my balance, I will be responsible for all costs associated with such action.  These will include all attorney fees, court costs, interest on the unpaid balance, collection fees and any other such cost incurred to make English Inspection Services, Inc. whole for the work performed.  I personally guarantee payment of the account.  I represent and affirm that I have read this waiver and understand and consent to its terms.

By clicking the "Submit" button below, I agree to this Service Agreement

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