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ORDER SERVICES
Property Address
*
Number of Bedrooms
*
Township
*
Expected Closing Date
Tax ID
OWNER/BUYER INFO
Name
*
Cell/Mobile Phone
Home Phone
Owner/Buyer Address
REALTOR INFO
Name
Company
Email
*
Mobile/Cell
Alt Phone Number
Fax
Mailing Address
Contact for service needs/arrangements
Owner
Realtor
Broker
Other
If other, who?
Send report via
Email
Postal Mail
Fax
PROPERTY INFO
Is there electric power?
Yes
No
Is the property vacant?
Yes
No
If yes, how long?
Services Requested - MUST PICK CASH/CHECK PRICE OR CREDIT CARD PRICE for specific service requested - call office with any questions NOTE THERE IS A $100.00 MAX RETURN FEE if we have to return to property to re-inspect septic or well due to inaccessibility or incomplete inspection first visit, could not get in, resample water well, check isolations, no power or water available first visit, etc.
Septic Only (Includes: "Locate And Expose Septic System") - $300.00 CASH/CHECK PRICE
Well Only - (Includes: Bacterial/Nitrate samples) - $265.00 - CASH/CHECK PRICE
Septic and Well (Includes: "Locate And Expose Septic System" and Bacterial/Nitrate Samples) - $375.00 CASH/CHECK PRICE
Dewinterize/Rewinterize - $100.00/well - CASH/CHECK PRICE
Locate, Expose and Diagram Septic System - $175.00/hr., 1 hour min. - CASH/CHECK PRICE
Lead Water Analysis (7-10 Day Turnaround by STATE of MI Lab) - $150.00 - CASH/CHECK PRICE
Arsenic Water Analysis (7-10 Day Turnaround by STATE of MI Lab) - $150.00 - CASH/CHECK PRICE
Nitrites (if requested, there is an additional 30.00 lab fee, check with underwriter/loan officer) - $30.00 - CASH/CHECK PRICE
Septic Only (Includes: "Locate And Expose Septic System") - $309.00 - CREDIT CARD PRICE INCLUDES ALL FEES (Processing fee)
Well Only - (Includes: Bacterial/Nitrate samples) - $274.00 - CREDIT CARD PRICE INCLUDES ALL FEES (Processing fee)
Septic and Well (Includes: "Locate And Expose Septic System" and Bacterial/Nitrate Samples) - $384.00 - CREDIT CARD PRICE INCLUDES ALL FEES (Processing fee)
Dewinterize/Rewinterize - $109.00/well - CREDIT CARD PRICE INCLUDES ALL FEES (Processing fee)
Locate, Expose and Diagram Septic System - $184.00/hr., 1 hour min. - CREDIT CARD PRICE INCLUDES ALL FEES (Processing fee)
Lead Water Analysis (7-10 Day Turnaround by STATE OF MI Lab) - $159.00 - CREDIT CARD PRICE INCLUDES ALL FEES (Processing fee)
Arsenic Water Analysis (7-10 Day Turnaround by STATE OF MI Lab) - $159.00 - CREDIT CARD PRICE INCLUDES ALL FEES (Processing fee)
Nitrites (if requested, there is an additional 30.00 lab fee, check with underwriter/loan officer) - $39.00 - CREDIT CARD PRICE INCLUDES ALL FEES (Processing fee)
Septic RX - General check of septic system for homeowners - should do annually - $200.00 - CASH/CHECK PRICE
Well RX - General check of well system for homeowners - should do annually - $200.00 w samples $250.00 - CASH/CHECK PRICE
Sewer Line Scope - check line from house to private septic or public sewer - $200.00 - CASH/CHECK PRICE
Sample Well or City Water - includes bacteria/nitrate sample - $100.00 - CASH/CHECK PRICE
Septic RX - General check of septic system for homeowners - should do annually - $209.00 CREDIT CARD PRICE INCLUDES ALL FEES) (Processing fees)-
Well RX - General check of well system for homeowners - should do annually - $209.00 w samples $259.00 - CREDIT CARD PRICE INCLUDES ALL FEES) (Processing fees)
Sewer Line Scope - check line from house to private septic or public sewer - $209.00 - CREDIT CARD PRICE INCLUDES ALL FEES) (Processing fees)
Sample Well or City Water - includes bacteria/nitrate sample - $109.00 - CREDIT CARD PRICE INCLUDES ALL FEES) (Processing fees)
Payment ADD ALL CHARGES (Including travel fee, if applicable) BEFORE PROCESSING CREDIT CARD or TOTAL FOR CHECK/CASH
*
Credit Card (immediate payment online with CC info)
Completion of Service
Has the home been winterized?
Yes
No
House dewinterized and ready to sample?
Yes
No
Keybox/Combination Code
Travel Fee (Outside 20 Mile Radius)
*
Allegan - $25.00
Barry - $0.00
Berrien - $35.00
Branch - $25.00
Calhoun - $0.00
Cass - $25.00
Hillsdale - $35.00
Ionia - $35.00
Kalamazoo - $0.00
Kent - $35.00
Newaygo - $50.00
Muskegon - $50.00
St Joseph - $25.00
Van Buren - $15.00
Date of Submission
Additional Information
