HomeMy WebLinkAboutMiscellaneous - 28 APPLETON STREET 4/30/2018N_
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DANIEL A. GIARD
130A Appleton Street
NORTH ANDOVER, MA 01845
Phone 686-7653
STATEMENT
DATE V-24 13
TERMS:
PLEASE DETACH AND RETURN WITH YOUR REMITTANCE s
DA�.TE`7-1777'7;N"-V-0 I C4E CE
BALANCE FORWARD
DANIEL A. GIARD PAY LAST AMOUNT
IN THIS COLUMN
PRODUCT 100-2 � Inc., Grolon. Mm, 01471 To Ordw PHONE TOLL FREE I AO -225 63N
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1. Nam
WATERSHED RESIDENTS QUESTIONNAIRE
J','_1N C.-Ic fQ 6'T 1-k
2. Street Address S S -J"I 'i j v �t_
3. How many members are in your household? 10)-
4. What type of sewage disposal system do you have?
El cesspool
X septic tank and leaching area
El connection 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?
�& yes [I no [I do not know
6. How old is your sewage disposal system? El 0-5 years El 6-10 years El 11-20 years
4 over 20 years El do not know I
7. Has your sewage disposal system been rebuilt or repaired?
El yes 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? annually
N every 2-4 years D every 5-10 years El over 10 years [I never
9. Have you had any problems with your sewage disposal system? 0 yes no
If yes, what problems?
El repeated pump -outs needed
system clogs, backs up, or drains slowly
odors
El sewage surfaces through ground
10. How many of each appliance are connected to your sewage disposal system? I
washing machine dishwasher _Ie!�_ 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 C Pt S_ C I'A "zz> k�
clotheswasher 'A
12. Does your property have a lawn? Er yes El no
If yes, approximately what size?
El less than 1/4 acre 91 1/4 acre El 1/2acre 3/4 acre 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
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.
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