Private Sewage Treatment System
Site Address
Age of House
Total Square Feet
Size of Lot
Number of Bedrooms
Number of Baths
Any animals/dogs on-site
Date last occupied
Number of Past Occupants
Number of Future Occupants
Water District
When was Septic Tank last pumped
Past Problems/Leakage of System
If repaired, when
What was repaired
Applicant Name
Phone
Email
Realtor Name
Realty Company
Realtor Phone
Realtor Email
Date Pumper Scheduled
Time Pumper Scheduled
Sanitary Disposal Contractor/Pumper Name
Pumper Phone Number
Pumper Email
By clicking Continue you agree to the following statement. **Note-tanks must be pumped by a licensed Sanitary Disposal Contractor at the time of the City Re-Sale Inspection by the De Soto Building Inspection Department.