HomeMy WebLinkAboutMiscellaneous - 134 SANDRA LANE 4/30/2018 134 SANDRA LANE
210/097.0-0085-0000.0
WATERSHED RESIDENTS QUESTIONNAIRE
1. Name
r -
2. Street Address
3. How many members are in your household? 3
4. What type of sewage disposal system do you have?
❑ cesspool
El se tic tank and leaching area
connection to municipal sewer
❑ other (describe)
❑ do not know
5. Are the plans (drawings) for yo r sewage disposal system on file with the Board of Health?
❑ yes ❑ no E!Ydo not know,--.-
6.
now,6. How old is your sewage disposal system? Ek 0-5 years ❑ 6-10 years ❑ 11-20 years`
❑ over 20 years ❑ do not know
7. Has your sewage isposal system been rebuilt or repaired?
❑ es P' no ❑ do not know
Y -
If yes, approximately how long ago? years. What was done?
8. How frequently is your sewage disposal system pumped out? ❑ annually .
[I every 2-4 years ❑ every 5-10. years. El over 10 years never
9. Have you had any problems with your sewage disposal system? ❑ yes L311no
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 toyour our sewa a disposal system?
washing machine V dishwasher garbage disposal
�
dehumidifier drain sump pump toilet
roof/pavement drains showerlbathtub
11. Please state the brand and type (11quid or powder) of detergent you use for:
dishwasher - CFS �r��� !)QN ifl r fl-T"
clotheswasher Lf Q!.,li%
12. Does your property 3have a lawn? Yes no
If yes, approximately what size?
❑ less than 1/4 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
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.