Request a Class H Septic Inspection

Please complete the form below to request a Class H inspection, or you can download the form here.

Please complete the form thoroughly.
If we do not have the required signatures, the inspection will not be performed.
If the agent signs for the customer, he or she will be responsible for payment if it is not provided by the buyer/seller.
Septic inspection includes the pumping of a 1000 gallon septic tank, the paperwork required for real estate transactions and DNREC. If a permit is not available, time and labor will be added to the cost after the first hour of service. This will be an additional $150.00 per hour.

Please note, the cost of a septic inspection is based on location.

Please Call the Office for Pricing

Requested By:

Party Responsible for Payment

Name: *

Address:

Phone:

Email Address: *

Signature:

Seller

Inspection Address & Homeowner Information:

Name:

Street Address:

City:

State:

Zip Code:

Directions:

Phone:

Tax Map #:

Permit #:

Year septic was installed:

Age of structure:

Number of bedrooms:

Number of residents:

Occupied:

Length of vacancy:

Last pump out date:

Pumping frequency:

Who pumped the tank?:

Repairs to septic system:

Is this a second opinion inspection?:

Is there a water treatment system discharging into the system?:

Does grey water discharge somewhere other than the septic system?:

If the septic system was installed prior to 1985 please provide the previous owners names:

This information can be found on the deed to the property.

Realtor Contact Information

If you would like your realtor to have a copy of the inspection, please enter your realtor's contact information.

Name:

Phone:

Email Address:

Payment Method

Payment is due at the time of inspection. Buyer/ Seller/ Realtor must be on site to provide payment or pay prior to the septic inspection by check or credit card.

Insepction Paperwork required by:

Midway Services, Inc. will perform a Class H Septic Inspection for the above tax map number. Midway Services, Inc. will not be held responsible for any changes that may occur to the septic system after the date of the septic inspection.

I understand that by signing this paper, I will not hold Midway Services, Inc. liable for any future problems that may occur. I will also be responsible for providing payment at or before the time of the inspection.

Date:

Signature:

Verification: * verification image, type it in the box