Town of Hope Sewer Survey Question Title * 1. Address Name Address Address 2 City/Town State/Province ZIP/Postal Code Email Address Question Title * 2. Are you aware of any problems with with the sanitary sewer system in the Town of Hope? Yes No Question Title * 3. Do you reside in an area or have a business where there are issues with wastewater or high water following a large rain? Yes No Question Title * 4. If you answered yes to the previous question, have you had any of the following problems Water covers the road Observed sewer manhole Unable to use washing machine Unable to use dishwasher Unable to use shower Unable to use toilet Other (please specify) Question Title * 5. How many times a year are you affected by a large rain event? One time a year 2-5 times a year 6-10 times a year Never Other (please specify) Question Title * 6. In the past 3-5 years have you contaced the Town of Hope with a complaint regarding a sewer problem? Yes No Question Title * 7. Do you have photos of any of the above problems or issues that you are able to deliver to the Hope Town Hall so it may be included in the application Yes No Question Title * 8. Do you see the need for the Town of Hope to submit a grant application to assist with Wastewater System Improvements needed to maintain compliance by IDEM? Yes No Question Title * 9. Additional Comments Done