S. Loomis, Inc.

Name:

E-Mail Address:

Phone Number:

Service Address:

City / Town:

How do you prefer we contact you?

Phone

E-Mail

Text Msg

First Preference Service Date:

Second Preference Service Date:

Third Preference Service Date:

AM (8-10)

Preferred Time:

AM (10-12)

PM (12-3)

LATE (3-7)

Septic Tank Size:

(leave blank if unknown)

Comments, Special Requests or Instructions:

If you would like to schedule a routine septic tank cleaning you may fill out the form below.
We will then contact you (via your preferred method of contact) with a date and time for
your service.

If you require urgent service please call our office at (413) 357-8597.