I always tell our clients that are buying an older home it is.
The company you hire is very important. Don't hire the companies that also repair sewers. At $5000 to $25,000 for a major repair, it is cheap insurance. Ask if they pull toilets if necessary.
We were on an inspection yesterday and the scoping company would not pull a toilet, and could not get his camera all the way to the street sewer. The customer paid $250 (too much) for marginal service and still has no idea if the sewer is okay.
If you need a referral for a quality company, give us a call, we work with them all the time.
Some tips to be looking for are:
1)Sewer snakes, root growth inhibitors, and excesive drain cleaners.
2) If there is a sewer cleanout and the cap is different from the rest of the plumbing, (ie a rubber expansion plug in a cast iron drain) instead of the original brass cap, there had likely been work done on the sewer lines.
3)Look for stains at the floor drains in basements, foul odors, and tags from a sewer cleaning companies.
4)Sinkholes in the yard and movement of the soils, especially for steeply sloped lots.
We recently got a note from a client after they had a sewer check after we recommended it. This home was 100 years old and they had 4 bottles of drain cleaners in the basement. He said, "We used (a recommended vendor) per your recommendation (and suspicion during the inspection). It revealed a ~$1,500+ issue that could have turned worse down the road, so it was $195 well spent."

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Haven't had any inspectors say anything about the sewer pipes but it is interesting.
I always tell my clients, the sewer is the most expensive part of the home we cant see. I have a friend that is a local home inspector, and he said he never recommends a scope. I think it is good customer service to inform buyers about this practice. We have a local municipality (Tacoma) that is considering making it mandatory part of the sale. While I am not advocating that position, I so think all buyers should know the risks verses the cost of having it done.
http://www.cityoftacoma.org/Page.aspx?hid=14155
People are complaining about the added cost. At $200, it is a bargin if it keeps a buyers from spending tens of thousands of dollars in my opinion.
Great post! I especially like the part about sinkholes in the yard. Surely something going on there.
Thank you,
Richard Acree
http://habitecinspections.com
We have a few neighborhoods around here with houses still connected to orangeburg sewer drains. When I see them, or especially new PVC plastic plumbing clean outs in other yards nearby, I point it out to the clients and suggest a scope! Like you say, cheap insurance!