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Home My WebLink AboutMiscellaneous - 86 SOUTH BRADFORD STREET 4/30/2018 (2)00 o M o O wao gg 1pX 0 00 C3 m oM -i H 14 2. 1 �J � V L �J 1 1 V 1 �l 1 V 1'•111\ L 1. Name :Br L't� �''y &(-/1 u)-1 - 2. Street Address g & `-'' �� •�'� S �' 3. How many members are in your household? 4. What type of sewage disposal system do you have? ❑ cesspool Er- septic tank and leaching area ❑ connection to municipal sewer PY other (describe) e'_ ❑ do not know S. Are the plans (drawings) for your sewage disposal system on file with the Board of Health? [rYyes ❑ no F-114not know .• -_ ❑ 11-20 years.:_: 6..:.How_old.is your sewage disposal system?. El. ..0-5 years Rover 20 years ❑ do not know 7. Has your sewage disposal system been rebuilt or repaired? ❑ yes ❑ no [ --ao not know If yes, approximately how long ago? ❑ .6-10 years years. What was done? 8. How frequently is your sewage disposal system pumped out? B"annually ❑ every 2-4 years ❑ every 5-10 years ❑ over 10 years ❑ never 9. Have you had any problems with your sewage disposal system? P_yes ❑ no If yes, what problems? - = [repeated pump -outs needed /-�/�� v� c�C -► ^-» �--� C 'system clogs, backs , or drains slowly [-?'odors( `�'� l� El sewage surfaces through ground ..10. How many of each appliance are connected to your sewage disposal system? washing machine dishwasher garbage disposal 3 ehumidifier drain sump pump toilet roof/pavement drains shower/bathtub 11. Please state the brand and type (li uid or powder) of detergent you use for: dishwasher a �' clotheswasher 44 12. Does your property have a lawn? D-11yes ❑ no If yes, approximately what size? ❑ less than 1/4 acre ❑ 1/4 acre ©--f/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 Season(s) of the year �- 14. Please state the brand and�type (liquid or granular) of lawn fertilizer you use: 0 Check here if your lawn is maintained by a professional landscape contractor. SEPTIC SYSTEM INSPECTION FORM ADDRESSr��, DATE INSPECTEDp PROPERLY FUNCTIONING? N WEATHER CONDITIONS COMMENTS: WA7E:P, a V A L 17 y rrEs + EI', L Ti 5� DYE TEST PERFORMED? Y N DATE? SKETCH: WATERSHED RESIDENTS QUESTIONNAIRE 1. Name o ,- 2. Street Address 3. How many members are in your household? S 4. What type of sewage disposal system do you have? ❑ cesspool C5' septic tank and leaching area ❑ connection to municipal sewer P- other (describe) L _ ❑ do not know 5. Are the plans (drawings) for your sewage disposal system on file with the Board of Health? C' 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 ❑ do not know 7. Has your sewage disposal system been rebuilt or repaired? ❑ yes ❑ no ❑ado 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? 2 -1 -yes ❑ no If yes, what problems? - - [-repeated pump -outs needed0- 5��system clogs, backs, or drains slowly I�odors (� w r l-� El sewage surfaces through ground j 10 How many of each appliance are connected to your sewage disposal system? �z `%%•,., washing machine ✓ dishwasher 1 garbage disposal L_ 'o;�- <,�'�deumi hdifier drain sump pump toilet roof/pavement drains shower/bathtub 11. Please state the brand and type (li uid or powder) of detergent you use for: dishwasher a clotheswasher 4 12. Does your property have a lawn? Iii --yes ❑ no If yes, approximately what size? ❑ less than 1/4 acre , ; ❑ 1/4 acre [9-�/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 Season(s) of the year 14. Please state the brand and type (liquid or granular) of lawn fertilizerY ou use: ❑ Check here if your lawn is maintained by a professional landscape contractor.