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Sewer Backup Survey

1. What is your street address*
2. In the past month, have you experienced sewer backup?*
Yes
No
Please confirm the date(s) when sewer backup occurred:
Please confirm the date(s) when sewer backup occurred:
Please confirm the date(s) when sewer backup occurred:
Please confirm the date(s) when sewer backup occurred:
Please confirm the date(s) when sewer backup occurred:
3. In your opinion, do you feel sewer backup occurrences from this past month were overall more or less intense than those experienced prior to upgrading your plumbing system?*
More
About the same
Less
No backup experienced
4. Have you taken any additional precautions that may have influenced the intensity of sewer backup occurrences?*
Yes
No
If yes, please indicate which of the following apply/were affected:

All fields marked with an asterisk (*) are mandatory.
 

Note: Information collected with this feedback survey will be used for research and future program purposes.