HomeMy WebLinkAboutMiscellaneous - 89 LISA LANE 4/30/2018 (2)WATERSHED RESIDENTS QUESTIONNAIRE
1. Name
2. Street Address
3. How many members are in your household? 2
4.
What type of sewage disposal system do you have?
❑ cesspool
❑ septic tank and leaching area
[v]l-'connection to municipal sewer
❑ other (describe)
❑. do not know
5. Arethe plans (drawings) for your sewage disposal system on file with the Board of Health?
Wr yes ❑ no ❑ do not know_ /
6. How old is your sewage disposal system? El 0-5 years EP 6-10 years ❑ 11-20 years
❑ over 20 years ❑ do not know
7. Has your sew,_a,g/e disposal system been rebuilt or repaired?
El yes [e 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 R -Ino
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 f garbage disposal
dehumidifier drain sump pump toilet
roof/pavement drains shower/bathtub __2__
11. Please state the brand and type (liquid or powder) of detergent you use for:
dishwasher s crgl C---
clotheswasher o, c G &u C
IV
12. Does your property have a lawn? Y yes ❑ no
If yes, approximately what siz
❑ less than % 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
O Season(s) of the year
61
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
7
❑ Check here if your lawn is maintained by a professional landscape contractor.