New Service Contract Form

Service Contract Form

Hey there, Environmental Septic services here. Please complete out this form to select your service level, provide contact and payment information for your septic maintenance contract. After completion the contract will be created and sent to the county completely done for you. No Hassle.
Septic System's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address (if different from septic address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Contract Start Date (if known)

MonthDayYear
Date
Contract Length
Service Level
Best Form of Communication
Special Instructions - If you have a Dog in yard, gate code, etc.
Mention anything!

Preferred Payment

Payment can be made via phone, Bank Draft (ACH), Card, Zelle and PayPal; or on our main website via "Pay Invoice". (Zelle available using our phone number (214-325-8028). All payment information is held privately, secured and never shared.
Preferred Payment Type

Bank Draft (ACH) Payment

All payment information is held privately and never shared.
Bank Account Number
For ACH draft
Routing Number
For ACH draft
Bank Name
Name of bank
Name on Account
First & Last Name
Signature

Credit/Debit Card Payment

To sign up for monthly payments please pay by card over the phone by speaking to the owner Lori, at 214-325-8028. All payment information is held privately and never shared. Monthly payment are available by phone only!

Phone Payment

By selecting phone payment and signing below you agree to receive a phone call from Environmental Septic Services collecting pay during Environmental Septic Services' normal servicing hours 8:00 AM to 5:00 PM Money through Friday. We are super friendly and love to talk any additional details on your account. Your contract will not go into affect until payment is collected. Thank you so much for choosing us.
Name on Account
First & Last Name
Number to call for payment
Signature

Commercial Contracts

New businesses or churches seeking a maintenance contracts require a custom commercial contract. To set up, please call Lori for prices and information.
Call Now at: 214-325-8028

Installations

If your interested in having a system Installed please call Lori for prices and information.
Call Now at: 214-325-8028
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Welcome!