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* 1. Basic Information

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* 2. Property Address (all fields must be completed)

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* 3. Tax Parcel ID Number (this can be found on your mailer)

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* 4. What Town is your property located in?

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* 5. How do you currently dispose of your sanitary sewage?

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* 6. Are there portions of your property which are not connected to your wastewater disposal system?

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* 7. Approximately how old is your wastewater disposal system?

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* 8. Do you know the location of your wastewater treatment system?

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* 9. How frequently do you perform maintenance of your wastewater disposal system (pump out septic tank/holding tank)?

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* 10. Have you ever performed a dye test?

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* 11. Have you ever experienced any problems with your current wastewater disposal system?

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* 12. Have you or any of your neighbors experienced a failure of a septic system (i.e., outbreak, "mushy" ground, foul odors, sewage backup etc.)?

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* 13. Are you concerned about the remaining "life" of your current wastewater disposal system?

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* 14. What is the depth to bedrock where your leach field is located?

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* 15. Is your leach field or property located near a waterbody or wetland?

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* 16. Are you on private water (well)?

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* 17. If you are on private water (well), have you ever experienced contamination of your drinking water?

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* 18. Comments:

0 of 18 answered
 

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