HomeMy WebLinkAboutMiscellaneous - 92 SANDRA LANE 4/30/2018C
WATERSHED RESIDENTS QUESTIONNAIRE
&W'41Z1. Name 7-O SCJ
2. Street Address 9'1 "ti A'
3. How many members are in your household?
4. What type of sewage disposal system do you have?
❑ cesspool
❑ septic tank and leaching area
Vconnection to municipal sewer
❑ other (describe)
❑ do not know
5. Are the plans (drawings) for ur sewage disposal system on file with the Board of Health?
El yes El no Ido 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 C+"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 1 garbage disposal
dehumidifier drain sump pump toilet
roof/pavement drains shower/bathtub -3
11. Please state the brand and typ(liquid or powder) of detergent you use for:
dishwasher c
clotheswasher 7.LDE -Z
12. Does your property have a lawn? es ❑ no
If es, approximately what size?
less than 1/4 acre ❑ 1/4 acre ❑ % acre ❑ 3/4 acre ❑ 1 acre
❑ more than 1 acre (Specify) acres
13. How often do you fertilize your n?
No. of applications per y r
Season(s) of the year
14. Please tate the bran and pe (liquid or granular) of lawn fertilizer you use:
k r7j�c.SJ�t-/Jct-: /2f v)/�i2_
Ges
❑ Check here if your lawn is maintained by a professional landscape contractor.