HomeMy WebLinkAboutMiscellaneous - 5 SANDRA LANE 4/30/2018 (2) r
5 SANDRA LANE
2101098.A-0051_0000.0
r /
1
WATERSHED RESIDENTS QUESTIONNAIRE
1. Name �f�d�/C /--:-
/,,j%1 Al
7 2. Street Address �Sti`�
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A17
O3. How many members are in your household?
4. What type of sewage disposal system do you have?
❑ cesspool
❑ . septic tank and leaching area
,,g 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 EJ no El do not kno '---
6 .How old is your sewage disposal system?X 0-5 years ❑ 6-1.0 years ❑ 11-20 years
❑ over 20 years ❑ do not know
7. Has your sewage disposal system been rebuilt or repaired?
❑ yes 9 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
❑ every 2-4 years ❑ every 5-10 years ❑ over 10 years ❑ never
9. Have you had any problems with your sewage disposal system? El yes El 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 C/7,3 G'x1 /7f
clotheswasher y�f
12. Does your property have a lawn? yes ❑ no
If yes, approximately what size?
❑ less than 1/4 acre ❑ % acre kf' 1/z acre ❑ % acre ❑ 1 acre
❑ more than 1 acre (Specify) acres
13. How often do you fertilize your lawn?
No. of applications per year
OSeason(s) of the year /7 "/,�1�
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
- �•r' ' ,e Tvz Xis el,g,
❑ Check here if your lawn is maintained by a professional landscape contractor.