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FIGURE 7-3 <br />' SEPTIC TANK SURVEY <br />' 1. How old is your home? <br />How long have you lived in it? <br />Do you rent or own? <br />2. <br />Have you had any operational problems with your septic tank, such as <br />' <br />sewage backing up into the house or seeping up in the lawn, or a <br />clogged drainfield? <br />' <br />Explain the situation and any corrective action taken. <br />3. <br />Is there any objectionable odor or problems associated with your septic <br />tank? <br />' <br />Are they more prevalent (yes or no) <br />during period of heavy rainfall? <br />' <br />when water usage is high (when using the clothes washer or when <br />someone is taking a shower, for example)? <br />' <br />in the fall more than in other seasons? <br />4. <br />How often do you have your septic tank pumped out? <br />' <br />5. <br />When was the last time your septic tank was pumped out? <br />6. <br />Is your septic tank located in the front, side or back yard? <br />t7. <br />have <br />Do you a garbage grinder or a clothes washer? <br />' <br />8. <br />Check the statements below that apply: <br />I am in favor of constructing new sewers in my neighborhood, <br />whether grant assistance is available or not. <br />' <br />I am in favor of constructing new sewers in my neighborhood, only <br />if grant assistance is available. <br />' <br />I am opposed to constructing new sewers in my neighborhood. <br />If opposed to the sewer project: <br />' <br />I think that the is too high. <br />cost <br />' <br />I don't believe that the project is needed. <br />I am satisfied with my septic tank. <br />' <br />9. <br />Do you have any additional comments concerning this study? <br />10. <br />The following information is requested, but not required: <br />Name: <br />Address: <br />' <br />Telephone Number: <br />