HomeMy WebLinkAboutMiscellaneous - 83 SANDRA LANE 4/30/2018c
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WATERSHED RESIDENTS QUESTIONNAIRE
1. Name ST�IeC�0T l
2. Street Address 9'3 .�4AAAW LA)
3. How many members are in your household?
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? ❑ 0-5 years E�16-10 years ❑ 11-20 years
❑ over 20 years ❑ do not know
7. Has your sewa
gedisposal system been rebuilt or repaired?
❑ yes ❑ 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 9 --ho
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 —,a-
A.
11. Please state the brand and ty e (liquid or powder) of detergent you use for:
dishwasher
clotheswasher
12. Does your property have a lawn? C4 yes ❑ no
If yes, approximately what size?
❑ less than 1/4 acre ❑ 1/4 acre ❑ 1/2 acre E? 5/4 acre ❑ 1 acre
❑ more than 1 acre (Specify) acres
13. How often do you fertilize your lawn?
No. of applications per year a''
Season(s) of the year�G -L
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
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❑ Check here if your lawn is maintained by a professional landscape contractor.