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Licensed & Insured • VA 2705163102

Serving Central Virginia Since 2005

24/7 Emergency Service

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Septic Installation Form

This information will help our team provide an estimate and open your project for a new or replacement Septic Installation on your property.

"*" indicates required fields

Δ

Email

This field is for validation purposes and should be left unchanged.

1. Customer Contact Information

Name*

Email*

Enter Email Confirm Email

Phone*

Preferred Contact Method*

2. Property / Service Information

Service Address*

Street Address Address Line 2 City State ZIP Code

Is this the same as your mailing/billing address?*

Yes

No

Mailing/Billing Address

Street Address Address Line 2 City State ZIP Code

3. Type of Request

What service are you requesting?*

New Septic Installation (New Build)

Septic System Replacement

Septic System Repair / Upgrade

Not sure – need evaluation

4. Property & Home Details

Type of Structure*

Single-family home

Multi-family

Commercial

Number of Bedrooms*

Approximate Square Footage*

Property Use*

Full-time residence

Seasonal / vacation

Rental

5. Existing Septic System (if applicable)

Is there an existing septic system on the property?*

Yes

No

Not Sure

Current System Type (if known)

Conventional

Alternative

Conventional with pump

Unknown

Reason for Replacement / Repair*

System failure

Backup or surfacing sewage

Inspection failure (real estate)

Old / undersized system

Other

6. Soil / Perc Information

Has a soil evaluation or perc test been completed?*

Yes

No

Not Sure

Upload Soil / Perc Report (PDF)*

Accepted file types: pdf, Max. file size: 10 MB.

Would you like us to coordinate the soil test if needed?*

Yes

No

Optional Uploads

Site Plan / Plot Plan

Accepted file types: jpg, jpeg, png, pdf, Max. file size: 10 MB.

Previous Septic Design

Accepted file types: jpg, jpeg, png, pdf, Max. file size: 10 MB.

Health Department Permit (if already issued)

Accepted file types: jpg, jpeg, png, pdf, Max. file size: 10 MB.

Real Estate Inspection Report

Accepted file types: jpg, jpeg, png, pdf, Max. file size: 10 MB.

7. Site & Access Conditions

Is there adequate access for heavy equipment?*

Yes

No

Not Sure

Any known site challenges? (check all that apply)*

Trees

Sloped property

High water table

Utilities in work area

Limited access

Well on property?*

Yes

No

Not Sure

Distance of well from house to proposed system (if known).

8. Permitting & Timing

Current Permit Status

Not started

Submitted

Approved

Target Start Date*

MM slash DD slash YYYY

Deadline or Time Constraint*

Real estate closing

Certificate of occupancy

No deadline

9. Budget & Approval (Optional but Helpful)

Do you have an expected budget range? (optional)

Are you the decision-maker for this project?*

Yes

No

10. Additional Notes

Anything else we should know about the property or project? (Optional)

After form submission you will receive additional communication from our team on a cost estimate and timeline for your proposed project.

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Ready to Experience the Drainfield Solutions Difference?

Don’t trust your septic system to just anyone. Our experienced team is ready to provide the professional, reliable service your property deserves.

Call Drainfield Solutions Today!

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Virginia’s trusted septic and drainfield experts since 2005. Professional service, honest pricing, and emergency response available.

(804) 633-1808
17507 Richmond Turnpike
Milford, VA 22514
info@drainfieldsolutions.com

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Septic Installation
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Service Areas

Richmond, VA
Fredericksburg, VA
Petersburg, VA
Ashland/Hanover, VA
Chester, VA
Midlothian/Bon Air, VA
Colonial Heights, VA

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Business Hours

Mon–Fri: 8:00 AM–4:30 PM
Sat & Sun: Emergency Only

24/7 Emergency Service Available

Weekend / Evening Emergencies:
$285 additional fee (cash on site)

A 3.0% processing fee will be applied to all credit and debit card transactions

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Licensed & Insured • VA 2705163102