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Southern Oswego County
Sanitary Sewer Survey
*
1.
Basic Information
(Required.)
Name
Email Address
Phone Number
*
2.
Property Address (all fields must be completed)
(Required.)
Property Address
City/Town
State/Province
ZIP/Postal Code
*
3.
Tax Parcel ID Number (this can be found on your mailer)
(Required.)
*
4.
What Town is your property located in?
(Required.)
Hastings
Schroeppel
Volney
Other (please specify)
5.
How do you currently dispose of your sanitary sewage?
Septic tank and leach field
Holding tank
Cistern/dry well
Aerobic Treatment System
Unknown
Other (please specify)
6.
Are there portions of your property which are not connected to your wastewater disposal system?
All wastewater from my house is connected to my treatment system.
Kitchen Sink
Laundy/Washer
Garage Sink
Other (please specify)
7.
Approximately how old is your wastewater disposal system?
8.
Do you know the location of your wastewater treatment system?
Yes
No
9.
How frequently do you perform maintenance of your wastewater disposal system (pump out septic tank/holding tank)?
I have never performed maintenance on my system
If you have performed maintenance, please describe frequency and what maintenance was completed.
10.
Have you ever performed a dye test?
No
If yes, please provide details. How long ago and what were the results (pass/fail??
11.
Have you ever experienced any problems with your current wastewater disposal system?
No
If yes, please describe
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.)?
No
If yes, please describe
13.
Are you concerned about the remaining "life" of your current wastewater disposal system?
Yes
No
14.
What is the depth to bedrock where your leach field is located?
Less than 2'
2' - 4'
Greater than 4'
Not sure
15.
Is your leach field or property located near a waterbody or wetland?
Stream/River
Pond
Lake
Wetland
My property is generally wet but not near a waterbody/wetland
Unsure
No
16.
Are you on private water (well)?
No, I am connected to public water.
If yes, how far is your leach field from your water source?
17.
If you are on private water (well), have you ever experienced contamination of your drinking water?
No.
If yes, please describe.
18.
Comments:
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