Clone of Wastewater Treatment System Inspection

Wastewater Treatment System Inspection

Part 1: System Information
Property Owner Information:
Full Name

First NameLast Name
Property Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Property Owner Email
example@example.com
Owner Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Property Owner Phone Number
Format: (000) 000-0000.
Property Owner Agent / Representative Name
Property Owner Agent / Representative Phone
Please enter a valid phone number.Format: (000) 000-0000.
Property Owner Agent / Representative Email
example@example.com
Who will be paying for the inspection?
Who will be paying for the septic tank pumping?
Who do we contact once the inspection is scheduled prior to arrival at the property?

Age of Structure
Years
Age of System
Years
Number of Bedrooms
Bedrooms
Calculated # Gallons/Day

Other
Note:

An unfinished basement is considered two additional bedrooms. Design flow increased by 80 gallons per day for each additional bedroom over 6.
Additional Notes:
Explain if applicable
Is the structure occupied?
Number of current occupants
If unoccupied, length of vacancy
Weeks / Months
Number of prospective occupants

Is this a second opinion inspection?
Date of previous inspection:
If previous inspection occured
Is there knowledge of any repairs or modifications being made to the system? If so, please explain.
Garbage Disposal
Water Softener
Date of Last Pumping
Month / Year
Pumping Frequency
If known
Maintenance Provider
If known
Repair Contractor
If known
Are there any problems reported from past services?
If so, please describe:
Please attach any additional information.

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