Owner's sign off

Please fill this out and submit it in preparation for your Title V Inspection.

Required information has a red asterisk next to the question.
Owner's Sign off form

TitleVInspections.com
Owner's Name*

First NameLast Name
Email *
example@example.com
Address to be inspected*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How did you hear about us?
Do you have a realtor? What is their name and email address?*
How many bedrooms in the house? A bedroom is defined as a room with a ceiling height of at least 7', must contain a window, heat, electricity, and the expectation of privacy (door).*
How many total rooms in the house not including halls, bathrooms, and closets?*
How many people live in the house?*
Do you have a garbage grinder in the kitchen sink?*

yesno
Do you have a water filtration system that backwashes like a water softener?*

yesnoI don't know
Where does the backwash go?
Are all fixtures including the laundry connected to the same septic system?*

yesno We have two septic systemsno We have a laundry pit in addition to our septic system
Here are pictures of a schedule 40 (white plastic) building sewer and a cast-iron (black) building sewer.
What is your building sewer made of?*

plastic (Schedule 40)Cast Ironnot accessible (behind a wall or in a crawl space that is difficult to get to)
If your house a year round dwelling?*

yesno summer camp etc
Do you have a sump pump in your cellar?*

yesno
When was your tank pumped last? What company pumped it?*
I cannot do the inspection if it was pumped in the last 2 weeks.
Do you have an irrigation system in your lawn?*

yesno
Do you have a well?*

yes This is our sole source of water.yes We have town water too. The well is for irrigation onlyno We only have town water.
Have you had water problems in the cellar?*

yesno
Explain
Have you had a problem with septic backup, septic ponding in the yard or septic smell?*

yesno
Explain
The process of inspecting your septic system involves digging in your yard and damage to underground structures may occur. The repair will be at the owner's expense. We will try to be careful. We typically use tarps to protect your lawn and dig with a shovel to minimize damage. Please contact us as soon as possible if you have to cancel. $100 charge if canceled within 48 hours of the appointment and full payment is due if canceled within 24 hours of the appointment.
Do not pump the tank before the inspection.
Is this an official inspection that you want filed with the Board of Health? It must be an official inspection if you are selling your house.*

official inspection that will be filed with the Board of Healthunofficial inspection for the owner's interest only
Please bill me for the inspection. Prices are available at www.TitleVInspections.com.
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Please fill this out and submit it in preparation for your Title V Inspection.

Owner's Sign off form