HomeMy WebLinkAboutMiscellaneous - 72 LISA LANE 4/30/20181
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WATERSHED RESIDENTS QUESTIONNAIRE
1. Name A. (f q LONG l O v
2. Street Address 7� L 1,54 L 74 M
3. How many members are in your household?
4. What type of sewage disposal system do you have?
❑ cesspool
❑ septic tank and leaching area
i( connection to municipal sewer
❑ other (describe)
❑ do not know
5. A e 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 _
EJ over 20 years El do not kno
7. Has your sewage disposal system been rebuilt or repaired?
❑ yes 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
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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 4 N% 120 LO'D e P
clotheswasher n a U) o �R
12. Does your property have a lawn? yes ❑ no
if es, 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 �C �M L w
Season(s) of the year
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.