HomeMy WebLinkAboutMiscellaneous - 118 SUTTON HILL ROAD 4/30/2018 (2) SUTTON HILL ROAD �'ROad
2-101097.0-0035 0000.0
SEPTIC SYSTEM INSPECTION FORM
ADDRESS sv ftz V-x l 1
DATE INSPECTED
.PROPERLY FUNCTIONING? YY N
WEATHER CONDITIONS
COMMENTS :
11A 7E P, a; A L i i y es,o TS�
DYE TEST PERFORMED? Y N
DATE?
SKETCH:
WATERSHED RESIDENTS QUESTIONNAIRE
0—BERT B. SEGAL -
1. Name 118 SUTTON ffftt
•
2. Street Address
NORTH ANDOVER, MASS. 01345
3. How many members are in your household? '
4. What type of sewage disposal system do you have?
❑ cesspool
K septic tank and leaching area
❑ connection to municipal sewer
❑ other (describe)
❑ do not know
5. Are the plans (drawings) for your sewage disposal system on file with the Board of Health?
❑ yes ❑ no Q do not know--.-
6.
now--6. How old is your sewage disposal system? ❑ 0-5 years ❑ 6-10 years X 11-20 years==-
❑ over 20 years ❑ do not know .
7. Has your se wa a disposal system been rebuilt or repaired?
F-1yes no ❑ do not know
If yes, approximately how long ago? years. What was done?
8. How frequently is your sewage disposal system pumped out? 4J annually
❑ every 2-4 years ❑ every 5-10. years. ❑ over 10 years ❑ never
9. Have you had any problems with your sewage disposal system? ❑ yes ® no
-.� 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 Al
roof/pavement drains shower/bathtub
11. Please state the brand and type (liquid or powder) of detergent you use for:
dishwasher K�r�cTjse�.
clotheswasher
12. Does your property have a lawn?. Cd yes ❑ no
If yes, approximately what size? gyp{
El less than 1/4 acre F-11/4 acre ❑ 1/2 acre IAJ 3/4 acre ❑ 1 acre
❑ more than 1 acre (Specify) acres
13. How often do you fertilize your lawn? y
No. of applications per year
Season(s) of the year ►-ti-
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
C'[1n
Check here if your lawn is maintained by a professional landscape contractor.