HomeMy WebLinkAboutMiscellaneous - 131 SANDRA LANE 4/30/2018 (2) 131 SANDRA LANE
210/097.0-0070-0000.0
WATERSHED RESIDENTS QUESTIONNAIRE
1. Name M 4 :5 7-7-4
2. Street Address 3 L5 �' �� L �F
3. How many members are in your household? 6,4
4. What type of sewage disposal system do you have?
❑ cesspool
❑ septic tank and leaching area
8' 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?
Er yes ❑ no ❑ do not know
6. How old is your sewage disposal system? ❑ 0-5 years 6-10 years ❑ 11-20 years
❑ over 20 years ❑ do not know
7. Has your sewage disposal system been rebuilt or repaired?
❑ yes ❑ no QK do not know
If yes, approximately how long ago? years. What was done? _
8. How frequently is your sewage disposal system pumped out? ❑ annua y
❑ every 2-4 years ❑ every 5-10 years ❑ over 10 years 2 never
9. Have you had any problems with your sewage disposal system? ❑ yes R"*'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 yotir wage disposal system?
washing machine t/ dishwasher '/ garbage disposal
dehumidifier drain sump pump toilet
roof/pavement drains shower/bathtub ✓
11. Please state the brand and type (liquid or powder) of detergent you use for:
dishwasher G 4S G 04( ,4F
clotheswasher of
12. Does your property have a lawn? ✓r yes ❑ no
If es, approximately what size?
less than 1/A acre ❑ 1/4 acre ❑ 1/2 acre ❑ 3/4 acre ❑ 1 acre
❑ more than 1 acre (Specify) acres
13. How often do you fertilize your lawn?
No. of applications per year
Season(s) of the year AP IW G PA L L_ S VM ra BBQ
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
PYCheck here if your lawn is maintained by a professional landscape contractor.