HomeMy WebLinkAboutMiscellaneous - 168 SUTTON HILL ROAD 4/30/2018 (2) 168 SUTTON HILL ROAD ad.
210'0 5Q.?-0097-0000.0
1
WATERSHED RESIDENTS QUESTIONNAIRE
1. Name -_./ O S S // FV
T o
2. Street Address Su TTa i� /-//z`
3. How many members are in your household? ?'
4. What type of sewage disposal system do you have?
❑ cesspool
❑ septic tank and leaching area
.R 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``='
❑ over 20 years ❑ do not know
7. Has your sewage disposal system been rebuilt or repaired?
❑ yes ❑ 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 an problems with our sewage disposal system? ❑ es e no
Y Y p Y Y
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
`roof/pavement drains shower/bathtub —&e-_
11. Please state the brands Ge(l�ui�d or powder) of detergent you use for:
dishwasher
clotheswasher A L 4-
12.
12. Does your property have a lawn? V yes ❑ no
If yes, approximately what size?
❑ less than 1/4 acre ❑ 1/4 acre ❑ % 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
11 Season(s) of the year
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
VCheck here if your lawn is maintained by a professional landscape contractor.