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Compliance Inspection Questionnaire
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* Indicates required question
Name
*
Your answer
Parcel Number
Your answer
Address
*
Your answer
Phone Number
*
Your answer
Email
Your answer
Preference for Receiving Invoice & Inspection Report
*
Mail
Email
Both
Reason for Inspection
*
Zoning / Permit
Real Estate Transaction
Lake Study
Other:
Type of Septic System
*
Holding Tank (tank only, no drainfield)
In-Ground System
Mound System
Other:
Are there any known issues with the septic system?
*
No
Yes
Briefly describe any known issues
Your answer
If you have a preferred septic pumper/maintainer, please list them below.
Your answer
By submitting this form, I agree to have Cubed B LLC complete a septic compliance inspection on the property listed above and to pay for the service.
(Fees are listed here)
*
Yes
No
Submit
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