HomeMy WebLinkAboutMiscellaneous - 61 RUSSETT LANE 4/30/2018 61 RUSSETT LANE
210/104.A-0049-0000.0
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Town of North Andover, MA
Watershed Septic System
serviciiiq Report
Date:
Homeowner: P-)j+ Pumper
Street "-�- Address: t
Phone Phone
Nature of Service: Routine 7`
Emergency
Observations: Good Condition
Full to Cover
Baffles in Place
Leachfield Runback
Excessive Solids
Heavy Grease
Roots
Other (Explain)
,Description of Work:
Comments:
y
SEPTIC SYSTEM INSPECTION FORM
ADDRESS CD i gt S s-4
DATE INSPECTED 9 - 06
PROPERLY FUNCTIONING? N
WEATHER CONDITIONS
COMMENTS :
WATER QUALITY TES T E'b Z
DYE TEST PERFORMED? Y N
DATE?
SKETCH:
\.y
WATERSHED RESIDENTS QUESTIONNAIRE
1. Name 5�LL
' 2. Street Address
3. How many members are in your household?
4. What type of sewage disposal system do you have?
❑ cesspool
[Rf 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 ❑ do not know`
6. How old is your sewage disposal system? ❑ 0-5 years 6-10 years ❑ 11-20 years`ti-=
❑ over 20 years ❑ do not know
7. Has your sewage disposal system been rebuilt or repaired?
❑ yes 2� no ❑ do not know
If yes, approximately how long ago? years. What was done?
S. How frequently is your sewage disposal system pumped out? ❑ annually
❑ every 2-4 years ❑ every 5-10 years ❑ over 10 years never
a 9. Have you had any problems with your sewage disposal system? ❑ yes [X 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 3
roof/pavement drains shower/bathtub _ �--
11. Please state the brand and type (liquid or powder) of detergent you use for:
dishwasher N P V�
clotheswasher
12. Does your property have a lawn? R1 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 Z
Season(s) of the year
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
S cv—,7-'� A,t=om I to- 20 -- 9
0 Check here if your lawn is maintained by a professional landscape contractor.