Water Testing & Well Inspection
Realtor Well & Water Form
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Requester: Name, Phone, & Email  *
Seller's Name *
Seller's Contact Information
Seller's Agent  *
Buyer's Name *
Buyer's Contact Information
Buyer's Agent  *
Tests Needed *
Required
Who should we contact to schedule the inspection/tests? *
Closing Date: *
MM
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DD
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YYYY
Deadline for results:
MM
/
DD
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YYYY
Property Address *
Lock Box # - Entry Instructions
If the property is vacant, the water will need to run for at least 8 hours prior to testing & inspection. 
(If the owner is unable to run the water, contact Complete Water to schedule an extra trip to run the water.)
 *
Required
Is it a shared well?   *
If it's shared, where is the equipment?
Who should be billed?  *
Will the invoice be paid at closing? *
If the invoice will be paid outside of closing, please explain.
If a septic inspection is needed, then please answer the following.
How many occupants?
How many bedrooms?
Are manhole covers above or below ground?
Clear selection
Is there a working hose bib? Where is it in proximity to the septic?
Submit
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