Pre-Inspection Septic Home Owner Survey
The completion of this form helps us understand how the system is being used and aids tremendously in your overall inspection.
Email address *
Inspection Address *
Owner Name *
Client Name *
Client Address *
Client Phone Number and Email *
Seller’s Agent & Phone
Buyer’s Agent & Phone
Do You have a copy of the State Approved Septic Plan on hand?
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If no do you have a Sketch of where the Septic System Components are?
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Age of House *
House Occupied? *
If Vacant, For How Long?
If Occupied, How Long
How many people living/moving into the house? *
Do you have a Water Softener *
IF you have a Water Softener, Where it does it Discharge to?
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Do you Have a Garbage Disposal
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Do you have a Dishwasher
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Do you have Washing Machine
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Does the Washing Machine Discharge into the Septic Tank?
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Date of Last Pumping of Tank(s)
MM
/
DD
/
YYYY
Have There Been Any Concerns, Problems or Corrections to the System? *
If Problems with the system, what kinds?
Have There Been Fixtures Added to the Plumbing System of the House Since the Original Septic System was Installed? *
If Fixtures have been added, what Fixtures?
Additional Comments or Information
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