Contact your Septic Repair Expert at 253-220-6868.

 

HSCC1 & Services Inc.

P.O. Box 687,
Sumner Wa. 98390
T: 253.220.6868

F: 253 277-3651

E-Mail: HSCC1@comcast.net

 

 

Protecting your environment. Free estimates available on septic designs.

 

Authorization sheet

PROPERTY
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PARCEL
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Seller name/ email
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MAILING ADDRESS
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PHONE/ FAX
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AS-BUILT
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*Drawing showing all buildings & location of all septic components on property must be stamped AS BUILT

PETS
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OCCUPIED
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WATER & POWER
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RISERS
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*Risers have round lids at the ground level

GATE
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GATE CODE
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PUMPING NEEDED
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YEAR BUILT
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LOCK BOX CODE
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PAYMENT TYPE
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• *ALL ESTIMATES HAVE CASH/ CHECK DISCOUNT OF 3.5%, THIS WILL BE ADDED IF USING A CARD.
• PLEASE HAVE EXACT CHANGE IF USING CASH

-IF AS-BUILT DOES NOT HAVE ALL OUT BUILDINGS AND EXISTING SEPTICS SYSTEMS FOR THE PARCEL, A NEW ONE WILL HAVE TO BE DRAWN PER THE COUNTY HEALTH DEPT. IN ORDER TO FILE REPORT. (KING COUNTY)

ESCROW INFO
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ADDRESS
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PHONE
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FAX
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PAYER NAME
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ADDRESS
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PHONE #
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REALTOR INFO

NAME & COMPANY
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PHONE #
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-NOT RESPONSIBLE FOR ANY LANDSCAPING, SPRINKLERS, TREE OR ROOT DAMAGE, CRACKED OR DAMAGED CONCRETE OR ASPHALT DUE TO TRUCKS OR MACHINES NEEDED TO PERFORM JOB.
-OWNER RESPONSIBLE FOR UNMARKED OR MISMARKED UTILITIES.
-SIGNATURE REQUIRED FOR WORK TO BE PERFORMED

SIGNATURE FOR AUTHORIZATION(*)
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DATE
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