HomeMy WebLinkAboutMiscellaneous - 105 MARBLERIDGE ROAD 4/30/2018 (2)�'J
WATERSHED RESIDENTS- QUESTIONNAIRE
1. Name a /4 ' rL .5- /. e,
2. Street Address to
r-
3.
3. How many members are in your household? `O-
4.
What type of sewage disposal system do you have?
❑ cesspool
[septic tank and leaching area
❑ connection to municipal sewer
❑ other (describe)
❑ do not know
5. Are the plans (drawings) fo� ur sewage disposal system on file with the Board of Health?
❑ yes ❑ no Z do not know _
6. How old is your sewage disposal system? ❑ 0-5 years ❑ 6-10 years V/11-20 years
❑ over 20 years ❑ do not know -
7. Has your sewage/disposal system been rebuilt or repaired?
❑ yes o ❑ do not know
If yes, approximately how long ago?
years. What was done?
8. 7every
frequently is your sewage disposal system pumped out? ❑ annually
2-4 years ❑ every 5-10 years ❑ over 10 years ❑ never
9. Have you had any problems with your sewage disposal system? ❑ yes Hno
If yes, what problems? __-
❑ repeated pump -outs needed
❑ system clogs, backs up, or drains slowly
❑ odors .
❑ sewage surfaces through ground
10. How many of each appliance are connected to your sewage disposal system?
washing machine ( dishwasher garbage disposal
dehumidifier drain sump pump toilet 3
roof/pavement drains shower/bathtub 2-
11. Please state the brand and type (li uid or owder) of detergent you use for:
dishwasher _VeV-'N-f" x ti S
clotheswasher W ',sk
12. Does your property have a lawn? yes ❑ no
If yes, approximately what size?
❑ less than 1/4 acre ❑ % acre 1/2 acre ❑ 3/4 acre ❑ 1 acre
❑ more than 1 acre (Specify) acres
13. How often do you fertilize your law ?
No. of applications per year
Season(s) of the year
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
❑ Check here if your lawn is maintained by a professional landscape contractor.