HomeMy WebLinkAboutMiscellaneous - 145 JOHNSON STREET 4/30/2018 145 JOHNSON STREET t 1
21.01097.0-0030-0000.0
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WATERSHED RESIDENTS QUESTIONNAIRE
1. Name Aniela Zimny
2. Street Address 145 Johnson Street
3. How many members are in your household? 1
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) for your sewage disposal system on file with the Board of Health?
❑ yes ❑ no ❑ do not know -
6. How old is your sewage disposal system? ❑ 0-5 years ❑ 6-10 years ❑ 11-20 years-
9 over 20 years ❑ do not know
7. Has your sewage disposal system been rebuilt or repaired?
❑ yes a no ❑ do not know
If yes, approximately how long ago? years. What was done?
8. How frequently is your sewage disposal system pumped out? ❑ 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 X dishwasher garbage disposal _
dehumidifier drain sump pump toilet
roof/pavement drains shower/bathtub x_
11. Please state the brand and type (liquid or powder) of detergent you use for:
dishwasher
clotheswasher Qxydol
1 12. Does your property have a lawn? x❑ yes ❑ no
If yes, approximately what size?
❑ less than 1/4 acre ❑ 1/4 acre ❑ 1/2 acre ❑ % acre ® 1 acre
❑ more than 1 acre (Specify) acres
13. How often do you fertilize your lawn?
No. of applications per year none
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.