HomeMy WebLinkAboutMiscellaneous - 270 MARBLERIDGE ROAD 4/30/2018 (2)i
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WATERSHED RESIDENTS QUESTIONNAIRE
1. Name rn
2. StreetAddress MU&MOGfEz
3. How many members are in your household?
4. What type of sewage disposal system do you have?
El cesspool
El septic tank and leaching area
Vconnection to municipal sewer
El other (describe)
El do not know
5. Are the plans (drawings) for your sewage disposal system on file with the Board of Health?
[I yes El no El do not know
6. How old is your sewage disposal system? El 0-5 years El 6-10 years El 11-20 years
F-1 over 20 years EI do not know
7. Has your sewage disposal system been rebuilt or repaired?
[I yes El no El do not know
If yes, approximately how long ago? years. What was done?
8. How frequently is your sewage disposal system pumped out? El annually
El every 2-4 years El every 5-10 years El over 10 years El never
9. Have you had any problems with your sewage disposal system? El yes El no
If yes, what problems?
El repeated pump -outs needed
El system clogs, backs up, or drains slowly
El odors
El sewage surfaces through ground
10. How many of each appliance are connected to your sewage disposal system?
washing machine dishwasher –4— garbage disposal I
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? E/Yes El no
If yes, approximately what size?
El less than 1/4acre 0 1/4 acre acre 3/4 acre acre
F1 more than I acre (Specify) — acres
13. How often do you fertilize your la
No. of app lications per year
C t7 4 Z_
Season(s) of the year.
14. Please state the brand and type (Ii uid o ranula 'of lawn fertilizer you use:
0 Check here if your lawn is maintained by a professional landscape contractor.