HomeMy WebLinkAboutMiscellaneous - 850 OSGOOD STREET 4/30/2018 (2)O co
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WATERSHED RESIDENTS QUESTIONNAIRE
1. Name
2. Street Address
3. How many members are in your household?
4.
What type of sewage disposal system do you have?
❑ cesspool
VConnection
eptic tank and leaching area
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 diisRDsal system? ❑ 0-5 years El 6-10 years El 11-20 years _
El over 20 years LbJ' do not know
7. Has your sewa&wdisposal 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
Elevery 2-4 years Elevery 5-10 years Elll
over 10 years "ever
9. Have you had any problems with your sewage disposal system? Elyes P/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 tdype (liquid or powder) of detergent you use for:
dishwasher 7 Q�
clotheswasher
12. Does your property have a lawn? Vyes ❑ no
Ves, 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 yeara3-tom- _
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.