HomeMy WebLinkAboutMiscellaneous - 177 CHADWICK STREET 4/30/2018 (2)N
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WATERSHED RESIDENTS QUESTIONNAIRE
1. Name `' "/,
2. Street Address 7
3. How many members are in your household?
4. What type of sewage disposal system do you have?
❑ cesspool
❑ septic tank and leaching area
CS 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?
in 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 tK. 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
�J ❑ every 2-4 years ❑ every 5-10 years ❑ over 10 years 29 never
9. Have you had any problems with your sewage disposal system? )RI yes ❑ no
If yes, what problems?
❑ repeated pump -outs needed
t 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 showeribathtub /
11. Please state the brand and type (liquid or powder) of detergent you use for:
dishwasher /4,4,4—
clotheswasher 12 �^ "f ' 1✓' %' f
12. Does your property have a lawn? E7' yes ❑ no
If yes, approximately what size?
❑ less than 1/4 acre ❑ 1/4 acre 9 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 2 Pf i "v =�
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
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