EAST ARLINGTON VILLAGE QUESTIONNAIRE
This questionnaire seeks information as part of the ongoing wastewater study being undertaken by the Town of Arlington. To respond, either drop it off in the drop boxes located on the porch at Bonnie and Clyde’s (Old Mill Road at East Arlington Road), and the front entrance of Arlington Town Hall, 3828 VT Route 7A (open 24/7), or by email to nick.zaiac@arlingtonvermont.org. This questionnaire is also available at https://arlingtonvermont.org/the-latest/.
General Questions Associated with Village Water and Wastewater Solutions
1. What do you like most about East Arlington Village?
2. What concerns you most about the Village’s future?
3. What changes, if any, do you think would make the Village better?
4. Do you believe East Arlington Village would benefit from Community Wastewater?
a) Yes, Now!
b) Yes, but in the future
c) Maybe, in the future
d) Unsure
e) Not at all
5. Do you believe East Arlington Village Center could benefit from more affordable housing?
a) Yes
b) Maybe
c) Unsure
d) Not at all
6. Do you think an increase in industry and businesses would benefit East Arlington Village Center?
a) Yes (Please specify what)
b) Maybe
c) Unsure
d) Not at all
7. Do you have any other thoughts, concerns, or comments you would like to share about wastewater or water systems in your town?
8. To discuss your comments or concerns in greater detail, would you like a member of the Village Core Steering Committee or one of the consultants to contact you?
a) Yes, if so, please provide contact info
b) No
Questions about you and your property
1. What is your relationship to East Arlington?
a) I am a resident of the Village
b) I am a resident of the Town
c) I work in East Arlington.
d) Other, please specify
2. Are you a resident of the designated East Arlington Village or do you live in Town?
3. What type of property do you own? For example, is it a single-family home, an apartment building, or a commercial use?
4. Have septic capacity/function or water supply concerns limited what you can do with your property?
5. If septic capacity/function or water supply concerns have limited use of your property, please check any limitations that apply:
a) Adding a bedroom
b) Changing the use of my property
c) Adding an accessory (“in-law”) apartment
d) Expanding my business
e) Other (please specify)
6. Would a better septic system, or additional septic system capacity, benefit you or your business?
a) Yes, Now
b) Yes, but in the future
c) Maybe, in the future
d) Unsure
e) Not at all
7. Would a better water supply benefit you or your business?
a) Yes, Now
b) Yes, but in the future
c) Maybe, in the future
d) Unsure
e) Not at all
8. What is the source of your household water?
a) Arlington Water Department
b) Drilled Well
c) Dug Well
d) Spring
e) Other, please specify
9. Do you know where your private water supply or public water system connection and pipe system is?
a) Yes, precise location
b) Yes, approximate location
c) No
10. Is there a private water supply located on your property?
a) Yes
b) No, but I know where it is located
c) No
d) Unsure
11. Do you have more than one private water supply on your property?
a) Yes
b) No
c) Unsure
12. Do you know where your wastewater system is?
a) Yes, precise location
b) Yes, approximate location
c) No
13. Using the example and the space provided below please indicate the approximate location of your house or other building, driveway, septic tank, leach field, and water supply/water system connection. Is any portion of your property restricted from development by an easement, deed restriction, natural feature, or something else? If so, please indicate the approximate area on the sketch in the space above.
Questions on Your Experiences with your Wastewater System
1. Are you concerned about the condition of the septic system?
a) Yes
b) No
c) Unsure
2. If you are concerned about your septic system, why? Check any that apply to you:
a) Replacement Cost
b) Potential for Enforcement
c) N/A
d) Other/Please specify.
3. What information or support would you like about septic systems and capacity? Check any that apply
a) How well my system is working
b) How to maintain my system
c) How the State rules apply to my property
d) What alternatives or different systems are available
e) How much a repair/replacement system would cost, and if there’s help to pay for it
f) Other/please specify
4. Do you have a copy of any sketches, plans, or permits of your septic system available for reference?
a) Yes
b) No
c) Unsure
5. How old is your wastewater system (or what year was it installed)?
a) 2007 to Present
b) Prior to 2007 (Please specify year and permit number if know)
c) Unknown
6. Please indicate the size of your septic tank
a) 500 gallons
b) 1,000 gallons
c) 1,500 gallons
d) Unsure
e) Other (please specify)
7. Please indicate the construction material of your septic tank:
a) Concrete
b) Metal
c) Fiberglass or Plastic
d) Unsure
e) Other (please specify)
8. Does your septic tank have an effluent filter?
a) Yes
b) No
c) Unsure
9. Does your septic tank have an accessible cover at grade?
a) Yes
b) No
c) Unsure
10. How often do you have your septic tank pumped?
a) Every 1-2 years
b) Every 3-5 years
c) Every 6-10 years
d) Greater than 10 years
e) Unsure
11. What year was your septic tank last pumped, if known?
12. What type of treatment do you have after your septic tank?
a) In-ground leach field
b) Dry well(s)
c) Sand mound or raised leach field
d) Unsure
e) None
f) Advanced Treatment (describe if known)
13. Do you have a sump pump connected to your septic system?
a) Yes
b) No
c) Unsure
14. Is your wastewater system shared with another building or property?
a) Yes
b) No
c) Unsure
15. Please describe any upgrades or repairs that have been performed on your septic system within the last ten years:
16. Has your septic system ever been backed up?
a) Yes
b) No
c) Unsure
17. Does your septic system emit odors?
a) Yes
b) No
c) Unsure
18. Has your septic system ever failed and required replacement?
a) Yes
b) No
c) Unsure
19. If your system has failed and been replaced, when did it occur?
a) Specify Date:
20. Do you have wet areas in your yard?
a) Yes, if so specify:
b) No
c) Unsure
Questions on Your Experiences with your Public and/or Private Water Supply and System:
1. Are you concerned about your water supply system?
a) Yes
b) No
c) Unsure
2. If you are concerned about your public or private water supply system, why? Please check all that apply:
a) Replacement Cost
b) Quality and or Contamination Issues
c) Other/Please specify
d) N/A
Private Water Supply:
3. Have you ever tested your water supply?
a) Yes
b) No
c) Unsure
4. If you have tested your water supply, did your water have any known contaminates of concern, such as Arsenic, Uranium, Heavy Metals, Manganese or Lead?
a) Yes, please specify:
b) No
c) Unsure
5. If you have a drilled well, does it have a tag (aluminum)?
a) Yes, if yes, what is the date the well was installed? What is the driller number? What is the tag #/ id?
b) No
c) Unsure
6. Do you have any type of water treatment system?
a) Filter
b) Ultraviolet (UV) disinfection
c) Water softener
d) None
e) Other, please specify
7. Have you ever had contamination problems with the water supply system(s) on your property?
a) Yes, if so, please describe
b) No
c) Unsure
8. Have you ever run out of water?
a) Never
b) Every few years
c) Yearly
9. Has the property had any other problems with water, or has work been done on the water system in the last 10 years?
a) Yes, if so, please describe
b) No
c) Unsure
10. Are you interested in free water quality testing?
a) Very interested
b) I want more information
c) No, not interested