HomeMy WebLinkAboutMiscellaneous - 60 JOHNSON CIRCLE 4/30/2018 (2) 60 JOHNSON CIRCLE
210/097 O-0059-0000.0
WATERSHED RESIDENTS. QUESTIONNAIRE
1. Name AW AIAE L
2. Street Address I0 Ttob /yxoy"leeze //0 Ay've'el _ &,4 4/ t
3. How many members are in your household?
4. What type of sewage disposal system do you have?
❑ cesspool
❑ septic tank and leaching area
C( 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 ❑ 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 l& 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? ❑ 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 D toilet
roof/pavement drains 0 shower/bathtub
r '
11. Please state the brand and type (liquid or.powder) of detergent you use for:
dishwasher Cos rope
clotheswasher SoA D
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 ,9 3/4 acre ❑ 1 acre
❑ more than 1 acre (Specify) acres
13. How often do you fertilize your lawn
No. of applications per year
Season(s) of the yearyklA/6-
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
$1 Piet/t f.ZJ9/t
Check here if your lawn is maintained by�a professional landscape contractor.