Septic System Disclosure
Property Information
Property Address
Owner(s) Name
Date
Septic System Details
Type of System
Year Installed
System Capacity (gallons)
Location on Property
Permits Obtained
Yes
No
Unknown
Maintenance & Service History
Date of Last Inspection
Date Last Pumped
Service Provider(s)
Additional Notes
Known Issues or Repairs
Have there been any known issues, repairs, or failures?
Yes
No
If yes, please describe
System Components
Component
Present
Condition
Septic Tank
Yes
No
Drain Field
Yes
No
Distribution Box
Yes
No
Pump
Yes
No
Additional Comments
Seller's Signature
Date