HomeMy WebLinkAboutMiscellaneous - 71 MARBLERIDGE ROAD 4/30/2018 (2)O
P�
WATERSHED RESIDENTS QUESTIONNAIRE
1. Name J A M FS A &yD W E-NVY HYDE
2. Street Address 71 yvi Pt w, g ce: P( A c, c F�
3. How many members are in your household? 41
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 ❑ do not know
6. How old is your sewage disposal system? fM 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 C2C 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 El never
9. Have you had any problems with your sewage disposal system? ❑ yes Il no
i 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 k dishwasher X garbage disposal
dehumidifier drain 7< 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 &.5 (' "e
clotheswasher L Lu) -T) T D�
12. Does your property have a lawn?
If yes, approximately what size?
❑ less than 1/4 acre ❑ 1/4 acre
❑ more than 1 acre (Specify)
13. How often do you fertilize your lawn?
No. of applications per year
Season(s) of the year
❑ yes ❑ no LAwJN A/aT )N STALLED
ye'.
❑ 1/z acre ❑ % acre ❑ 1 acre
acres
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.