Sewer Inspection Camera Report

SEWER INSPECTION CAMERA REPORT

Report Date:   Job Number:

Client Name:

Service Provider:

Property Address:

WHEREAS

WHEREAS, Service Provider represents that it is duly qualified and experienced in performing closed-circuit television (CCTV) sewer inspections using industry-standard camera equipment and trained personnel; and

WHEREAS, Client desires to obtain a CCTV inspection and written report of specified sewer lines at the Property Address identified above and agrees to engage Service Provider under the terms set forth in this Report and accompanying service provisions; and

NOW, THEREFORE, the following inspection procedures, observations, findings and contractual provisions are recorded below and form the operative agreement between Client and Service Provider for the referenced inspection.

Scope of Work

Inspection Details

Inspection Date:   Start Time:   End Time:

Access Point / Cleanout Location:

Pipe Type:   Nominal Diameter:   Run Length Inspected (ft):

Camera System / Model:   Video Reference ID:

Condition Survey — Observations & Defects

Defect Types (check all observed):    Roots    Cracks/Fissures    Offset Joints    Infiltration    Grease/Buildup    Sag / Bellied Section    Broken / Missing Pipe

Severity Rating (1 = Minor, 5 = Immediate):   Location Along Run (ft from access):   Distance to Nearest Cleanout/Manhole:

Measurements & Elevations

Upstream Invert Elevation:   Downstream Invert Elevation:   Slope (%):

Recommendations & Repair Approach

Payment Terms

Inspection Fee (USD):   Payment Schedule:

Late Payment Fee:   Collection Costs: Service Provider entitled to recover reasonable collection costs and attorneys' fees if unpaid.

Term and Termination

Inspection Start Date:   Expected Completion Date:

Termination Notice Period (days):   Either party may terminate for material breach if the other party fails to cure within the notice period above.

Confidentiality & Liability

All non-public data, video recordings and written reports produced by Service Provider under this engagement are confidential and shall not be disclosed by Client without Service Provider's written consent, except as required by law. Service Provider retains ownership of raw video footage and diagnostic notes until payment in full is received, subject to applicable regulations.

Limitation of Liability: Service Provider's liability for claims arising from the inspection shall be limited to direct damages not exceeding the total fees paid for the inspection. Service Provider is not responsible for pre-existing conditions not observable via CCTV or for subsurface conditions that cannot be determined from a video inspection alone.

Governing Law

This Report and the contractual provisions herein shall be governed by and construed in accordance with the laws of the state of without regard to its conflict of law principles.

Entire Agreement

This Report, including its recitals, the Scope of Work and any attached exhibits or footage references, constitutes the entire agreement between Client and Service Provider with respect to the inspection described above. Any amendments must be in writing and executed by authorized representatives of both parties.

Inspector Certification

I certify that the inspection recorded in this Report was conducted under my supervision in accordance with standard industry practices for CCTV sewer inspection. Observations recorded here reflect the conditions visible to camera at the time of inspection.

Inspector Name:   License/Cert. #:

Sign Now