Project Assessment Survey
Fields in
Red
are required
Enter Your Contact Information
First Name
Last Name
Title
Agency/Company
Phone
Email
Address 1
Address 2
City
State
- -
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip
1.
Please provide a brief description of your management needs and you may also attach supporting documents.
Optionally Upload a PDF of Your Requirements:
2.
Do you have an estimated time frame to implement your program?
- -
No
12 Months
24 Months
36 Months
3
Please select the type of program(s) you are interested in managing.
3a.
System Identification(s)
Inventory
Registration
Locating
Mapping
Other:
3b.
Select the type of septic system(s) you are interested in managing.
Conventional
Innovative/Alternative Technologies
Step System
Holding Tanks
Cesspools
Residential
Commercial
Other:
3c.
Septic system waste disposal tracking
Yes
No
3d.
Fats, Oils & Grease (FOG) permit, service, and compliance tracking management
Yes
No
3e.
Well permit, service, and compliance tracking management
- -
Residential
Commercial
Both
Other:
4.
Data Migration: How many databases will you need to migrate to the management program?
- -
1
2
3
4+
5.
Would you like to regularly update your septic management database with your property tax records?
Yes
No
6.
Do you currently have septic system management rules and regulations in place? If yes, please give a brief description.
Yes
No
Description:
7.
Are you interested in any of full service options provided by Carmody?
Mailing Services
Send enforcement notices
Send notices (postcards, letters, etc.…)
Billing
Invoicing
Other:
Online Payment Services
Usage fees
Fines
Online invoice payment
Other:
Additional Services:
8.
Enter the total number of systems you would like to manage.
9.
Select the Database password assess levels you would like.
(Check all that apply)
The Carmody program has several password access levels. Carmody can set up password levels from State to Towns and everything in-between.
Our clients can choose the access level each password has to the database, administration, administration support, overview, report filing, assigned property view only, territory view only.
State
District
Community Service District
County
City
Town
Contractors
Property Owners
Public Access
Other:
10.
I would like the service reports to be filed by:
(Check all that apply)
In-house staff only
Approved contractors
Smart phone and tablet signature capabilities
Other:
11.
We offer several payment options for customer and tech support. Please select the option that you would prefer.
Month to Month
1-year Contract
3-year Contract
5-year Contract
Pay Per Report Filed
Per System
User Fees
Other:
*
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