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HomeMy WebLinkAboutMiscellaneous - 89 FOXHILL ROAD 4/30/2018C _ M N Ln O U T LL 4- 0 (1) �Z c e 0 o o o � w o c 0 s f O Q i Y f C � i 421 9.00 A � f ti w 0 oE C 1 -C 0 3 .o. D D Q 2 C L c m Lj F Q� _o Q V Qfo 0 E[] LL m ❑ U O C 0 0 Z WATERSHED RESIDENTS QUESTIONNAIRE 1. Name M)C6- �wlS 2. Street Address (fy O 3. How many members are in your household? 4. What type of sewage disposal system do you have? ❑ cesspool ❑ septic tank and leaching area L 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 ❑ 6-10 years ❑ 11-20 years • ❑ over 20 years ❑ do not know 101 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 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 I garbage disposal dehumidifier drain sump pump toilet 1.7 roof/pavement drains shower/bathtub __9_ 11. Please state the brand and type (liquid oryowder) of detergent you use for: dishwasher PotgpE.r. clotheswasher LiGzUi&— 05VA4 ' I �!6 12. Does your property have a lawn? If yes, approximately whatsiz Elless 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 ❑ 1/2 acre ❑ 3/4 acre ❑ 1 acre acres 14. Please state ` ate the brand and type (liquid or granular) of lawn fertilizer you use: �� ❑ Check here if your lawn is by a professional landscape contractor. 1. Name 2. Street Address TO 3, flow many members are in your household? 4. What type of sewage disposal system do you have? ❑ cesspool ❑ septic tank and leaching area V-,.- 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? ❑ ves ❑ no ❑ do not know 6. How old is your sewage disposal system?-❑ 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 ❑ no ❑ do not know VC 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 3. 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 6ehumidifier drain sump pump toilet rood/pavement drains showerlbathtub 11. Please state the brand and type (liquid orpowder) of detergent you use for: dishwasher Ae4ga � — (' CRD clotheswasher LiGiILO— 12. hoes your property have a lawn? ❑ yes ❑ no If yes, approximately what siz ❑ less than 1/4 acre '/4 acre ❑ 1/2 acre ❑ % acre ❑ 1 acre ❑ more than 1 acre (Specify) acres 13. H( -,w often do you fertilize your lawn? Nc). of applications per year •� Se,, son(s) of the year 14. Ple; ase state the brand and type (liquid or granular) of lawn fertilizer you use: S ri C-1 eck here if your lawn is maintain d by a professional landscape contractor.