Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Photo of House
People on Site
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Buyer
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Home Inspector
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Real Estate Agent
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Seller
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No One On Site
House Occupied
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Yes
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No
Plan On Site
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Yes
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No
Septic Tank Location
Septic Tank Type
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Metal
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Concrete
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Plastic
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Approx. Septic Tank Size
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500 gal
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1000 gal
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1250 gal
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1500 gal
Septic Tank Condition
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Poor
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Good
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Septic Tank Due For Pump Out
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Yes
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No
Inlet Baffle Type
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Plastic
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Concrete
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Missing
Inlet Baffle Condition
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Poor
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Good
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Outlet Baffle Type
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Plastic
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Concrete
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Missing
Outlet Baffle Condition
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Poor
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Good
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Pump Station
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Yes
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No
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Leach System Location
Leach System Type
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Drywell
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Pipe and Stone
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Concrete Chambers
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Plastic Chambers
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Elgin
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Enviro-Septic or Geo Flow
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Leach System Condition
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in Failure
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Poor
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Fair
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Good
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Additional Notes
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Add signature