HomeMy WebLinkAboutMiscellaneous - 174 SANDRA LANE 4/30/2018 (2)0
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WATERSHED RESIDENTS QUESTIONNAIRE
1. Name GeNmNP-o M&CCARO6
2. Street Address 114 4 D 12 A Lit
3. How many members are in your household? 14
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 year
❑ 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
—u' 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 t
dehumidifier drain 4 sump pump toilet 4
roof/pavement drains O shower/bathtub _sa__
11. Please state the brand and type (liquid or powder) of detergent you use for:
dishwasher I Alk) tJ
clotheswasher
12. Does your property have a lawn?
If yes, approximately what size?
less than 1/4 acre ❑ 1/4 acre
❑ more than 1 acre (Specify)
yes ❑ no
❑ 1/2 acre ❑ 3/4 acre ❑ 1 acre
acres
13. How often do you fertilize your la n?
O 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.