Your Septic Plumber-Rooter answer - Online septic tank cleaning form

Online Septic Tank Cleaning Form

Note: We service Fairfield & Westchester Counties for all septic and Plumber-Rooter work. However, we can ship kb-x-tendr and the sweet air anywhere in the world! If you are interested in these two items, please contact us right now!

All items marked with an * below are required to submit the form. Please be sure to fill them out completely.

You get $20.00 Off + $5.00 for Ordering Online!

Section 1.)
	I would like to have my septic tank cleaned and please:
*Name:
*Address:
*Town:
*Zip:
*Home #:
*Daytime #:

*Email :
	Please add my name to your e-mail list for future septic cleaning reminder notices.
	I am already a Plumber-Rooter / Kaiser-Battistone customer.

Please tell us how you heard about us:

Comments, Special Instructions,
& Phone Calling Details:

[If you are already a Kaiser-Battistone customer, please skip Section 2 and go to Section 3. We have all necessary information in our files.]

Section 2.)
Tank Size:	Fill in		Gallons

Do not know tank size.

If tank size is unknown please indicate the following

Bedrooms:

Age of House:

Section 3.)

We accept all major credit cards. Please indicate how you would like to remit payment.

Payment will be made via credit card.
[we utilize secure servers, your credit card information is encrypted.]

Billing Address if Different than in Section 1

Credit Card Type:

Credit Card Number:

Expiration Date (mm/yyyy)

Payment will be made via check.

What is 2+2?(Hint: The answer is 4). This is used to stop spam robots.

Thank you for being a Kaiser-Battistone Internet Customer. All our Web Site promotions and discounts will be applied after payment has been received.

We appreciate your business.

Visit our Plumber-Rooter Division for all your Professional Sewer and Drain Service Needs, Including Pipe Relining.