HomeMy WebLinkAboutMiscellaneous - 41 JOHNSON CIRCLE 4/30/2018 (2) 41 JOHNSON CIRCLE
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WATERSHED RESIDENTS QUESTIONNAIRE
1. Name T, Ik i 11.5 w; / i r.. LIL4 s
2. Street Address Ll I L � u s 0 K C , r c (-e
3. How many members are in your household? y
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 II 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 ❑ no V 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
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
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 01 as e-
clotheswasher 011eL I, L;-1;S k r Ko n s-u_
12. Does your property have a lawn? yes ❑ no
If yes, approximately what size?
❑ less than 1/4 acre ❑ 1/4 acre 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 3
Season(s) of the year
14. Please state the brand and type (liquid or granular) of lawn fertilizer you/use:
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❑ Check here if your lawn is maintained by a professional landscape contractor.