Site Address:
Listing Agent Name & Office
Listing Agent Office Address:
Listing Agent Phone #	Fax #		Cell #
Seller and/or Owners Name:
Seller and/or Owners address:
Seller and/or Owners Phone #
Buyers Agent Name & Office:
Buyers Agent Office Address:
Buyers Agent Phone #		Fax #		Cell #
Buyer Name:
Buyer Address:
Buyer Phone #
THE FOLLOWING MUST BE COMPLETED ENTIRELY
Has the dwelling been vacant for 7 days or more? *If YES then a Hydraulic Load Test is required. *Access to water must be on site for test, if not a fee for water transportation will apply.					Y / N
Is the manhole access cover(s) exposed on the septic tank? *If tank(s) are not exposed when service tech arrives on site there will be a $85.00 service charge. *Inspection and/or Hydraulic Load Test will not be performed if tanks are not exposed.					Y / N
If manhole is not exposed, would you like us to dig it up? *12 inches or less is dug by hand, deeper amounts equipment is used.					Y / N
Where is the septic tank(s) located on the property?
Approximate # of gallons septic tank capacity:
Please circle what payment terms are being utilized: Settlement NET 15 *If settlement is canceled, payment is due 15 days after service date. All late fees will apply.
Settlement date:
Person completing this form:					Date:
Comments:

Fins Environmental Service, LLC d/b/a Honey Wagon Septic

691 Truce Rd, Quarryville PA 17566 * Phone (717) 284-5228 * Fax (717) 284-2035

PRELIMINARY INFORMATION

No Services will be preformed until ALL paperwork is completed and returned