HomeMy WebLinkAboutMiscellaneous - 24 KIERAN ROAD 4/30/2018 (2)�. �
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WATERSHED RESIDENTS QUESTIONNAIRE
1. Name
2. Street Address
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3. How many members are in your household?
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. �Ae 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? X,
0-5 years ❑ 6-10 years ❑ 11-20 years --
❑ over 20 years ❑ do not know
7. Has your sewa disposal system been rebuilt or repaired?
El yes no ❑ do not know
If yes, approximately how long ago? years. What was done?
r 8. How frequently is your sewage disposal system pumped out? ❑ annually
❑ every 2-4 years ❑ every 5-10 years ❑ over 10 years ❑ never
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9. Have you had any problems with your sewage disposal system? ❑ yes 1 no
- If yes, what problems? v 1�
❑ 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 yo sewage disposal system?
washing machine dishwasher garbage disposal
dehumidifier drain sump pump toilet_
roof/pavement drains shower/bathtub
11. Please state the brand and type (liquid or powder) of detergent you use for:
dishwasher
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 ❑ nX o
❑ 1/2 acre 3/4acre ❑ 1 acre
acres
13. How often do you fertilize your lawn
` No. of applications per year
Season(s) of the year P -i V-166 F��--
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
I( Check here if your lawn is maintained by a professional landscape contractor.