Request Services 1General Information2Request Services3Access Details4Acknowledgments5Submit Step 1: General informationName PhoneYou are: Owner Realtor Owner and realtor Email Address County Township Do you need to include your realtor? Yes No Realtor Name* Realtor Phone* Realtor Email Address* Step 2: request servicesType of service/s* (select all that apply) Well Septic Samples Do you need a Lead Sample for Lending Purposes? Yes ($30. 3-5 day turnaround.) No I don’t know Step 3: Access detailsDo you plan to be present for the evaluation? Yes No Maybe Entry code/instructions (if you will not be present) Step 4: acknowledgementsAcknowledgement*I acknowledge that Hamilton Evaluation LLC and Joel Hamilton, owner/operator is not responsible for any damages occurring as a result of probing or uncovering septic tank lids or when assessing the final disposal. I understand that irrigation lines are not mapped and should not be located over any portion of the septic system.As natural gas and propane lines should also not be over the septic tank or drainfield/final disposal. Homeowner is responsible for their own repairs to the irrigation system or gas lines. If you do not wish for Hamilton Evaluation LLC or Joel Hamilton to uncover the septic tank to complete a septic evaluation for various reasons you opt to have the septic tank(s) pumped at owner’s expense. A proper pump card must be submitted to our office prior to the evaluation appointment. The following information must be on the pump card: size of the tank(s), type and condition of baffle(s), any run back noted, and if the water level was at proper operating level. Please note that if the water line is nicked while probing for the drainfield determining condition, Hamilton Evaluation is not responsible for damages as irrigation lines should not be over any part of the septic system. PAYMENT is due at the time of the scheduled appointment. We will not be able to release the report to you, your agent/lender until payment has been received. Payment by cash, check and credit card accepted. No cancellation fee if cancelled prior to appointment time. If we acquire a FOIA fee from a county for a records request, you will still be responsible for paying for a FOIA ($5-10 fee depending on county). In response, we will send you what the county provided us for your records. I agree No (if no, we will not be able to complete evaluation.) Liability Waiver and MISS DIG Requirement*We will call MISSDIG to locate all underground utilities. However, they will not locate any lines after the point of connection to your home (ei they are not able to locate any utilities that were put in by private contractors, so please let us know of any gas or electric lines you or previous owners have put in). By completing this online request for services, you accept responsibility (or accept responsibility on behalf of the owner) for all damages that occur from hitting all buried utilities, including but not limited to natural gas, propane, electric, telephone, cable, or buried underground fencing lines. The homeowner, or agent representing the owner, will not hold Hamilton Evaluations, it's employees or owners' responsible for any damages as a result of inspecting the well and septic. Buried utilities should not be in or over any portion of the septic system (Tank or drainfield). You acknowledge that if no county records are available through the health department, the inspector may have to probe all areas of the property to locate the septic system and damages can occur. I agree No (if no, we will not be able to complete evaluation.) Septic Tank Pumping* (select one) Purchase Agreement Requirement- Already Completed (please email pump card to us or have copy available at the time of the evaluation) Purchase Agreement Requirement- Will be completing after inspection (You want Joel to leave the septic tank uncovered for the pumper. We cannot return to bury the tank. Please ask your pumper to cover or owner is responsible for covering it back up) Only required if inspection will report that “Pumping is DUE” Not required to pump (Inspector will cover it back up) If a septic tank repair is necessary for functionality or to determine degree of deterioration of the tank, you acknowledge that the tank will be left uncovered and take responsibility to cover the tank after repairs. Step 5: submitSend me a copy of my responses? Yes No Upload current pump card or well and septic records Drop files here or Select files Max. file size: 32 MB. If you have a recent pump card, you can upload here or email to our office (firstname.lastname@example.org)Untitled First Choice Second Choice Third Choice NameThis field is for validation purposes and should be left unchanged.