A & B Septic - Tank Pumping & Drain Cleaning

Best Pots, Inc. & Site Locker

Order Services

Type of Services you require: (select one)

Pumping: Septic/Holding Tanks/Other
Line & Drain Cleaning
Line Repair
Cleaning Line to City
Pump System Service
Pump System Maintenance
Electronic Locating
Operation & Maintenance
Onsite Management
Other Services

Service is for: (select one)

Residence
Rental
Vacation
Commercial
Real Estate Transaction
Other Service

First Name:

Last Name:

Position/Title:

Company/Organization:

Address:

City:

State:

Zip Code:

Enter one or more of your phone numbers where you would like us to call you back.
At least one phone number is required please.

Work Phone:

Home Phone:

Fax:

Mobile Phone:

E-Mail Address: *Required

How would you like to be contacted?

Email Mail Fax Phone

Requested Service Date:

Requested Service Time:

Type of System: (select one)

Gravity
Sand Filter
Pump System
Recirculating Gravel Filter
ATT
Pressure
Other Type

Job Address:

Job City:

Job State:

Job Address Phone:

Do you need an inspection?

Yes No

Date Last Pumped:

Number of Occupants:

Number of Bedrooms :

Location of Tank, if known:

Tank Portal Exposed?

Yes No

Number of Acres:

Property Owner Name:

If Vacant, How Long?

Fax Inspection Report to:


Agent	Owner	Buyer	Other	Fax Number

Mail Invoice & Inspection Report to:


Agent	Owner	Buyer	Other	Address

Directions to Job Site Starting with Major Street, Hwy or Freeway:

Explain Problems you are having with System:

If you feel it is time to have your system serviced or if you have any questions, please give us a call at
Salem: 503-393-1311
Albany: 541-924-0851
Coast: 541-574-1656