Sustainable Yard Program w/PH application

Sustainable Yard Application

Please complete this application to be considered for the Pearl Home Sustainable Yard program. This program is available only to homeowners in the Lynnhaven watershed. The questions are designed to help us evaluate your site for one of the "Best Management Practices" (BMPs) available through this program.

The BMPs provided through this program include: a 125-gallon rain barrel, a Pearl Lawn Plan (an urban nutrient management plan), a rain garden, or an infiltration trench. Each home is eligible for only one BMP.

This program is available to homes within the Lynnhaven watershed only. Your site is not guaranteed a treatment and must be evaluated by LRNow staff during a physical site visit. Once your site has been approved by LRNow staff, a signed contract and a copay are required to proceed with the program. LRNow staff will work with you to schedule the installation.

The copay for each BMP within this program is:
$20 for the Pearl Lawn Plan with soil tests
$100 for the Rain barrel, the Rain Garden or the Infiltration Trench

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* 1. Address

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. Preferred method of contact:

Phone

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* 3. Are you the property owner?

Yes

No, I rent.

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* 4. How did you hear about this program?

Neighborhood Meeting

Neighborhood Newsletter

Social Media

Volunteer Event

Word of mouth

Garden club meeting

LRNow E-newsletter

LRNow website

Other (please specify)

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* 5. Are you currently a Pearl Home?

Yes - Please skip to question # 16

No - Please continue to question # 6

Unsure - Call our Pearl Homes Coordinator at 757-962-5398

Questions #6 - #15 will determine your status as a Pearl Home. Skip to question #16 if you are already a Pearl Home.

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* 6. If you are representing your student's school as part of the Pearl School program, please provide the school's complete name below.

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* 7. Please note if you would prefer to receive a Pearl Home flag or magnet.

Flag

Magnet

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* 8. My home is a(n)...

Single family home

Townhouse

Condominium

Apartment

Mobile Home

Tiny Home

Houseboat

Other

Other (please specify)

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* 9. Do you rent or own your home?

Own

Rent

Other

Other (please specify)

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* 10. REDUCE WASTE
Answer "YES" to the actions that you are consistently doing in your home and community.

	Yes	I don't now, but I will start	No	N/A
Consistently recycle or reuse items	Consistently recycle or reuse items Yes	Consistently recycle or reuse items I don't now, but I will start	Consistently recycle or reuse items No	Consistently recycle or reuse items N/A	Consistently recycle or reuse items
Use reusable grocery bags when shopping	Use reusable grocery bags when shopping Yes	Use reusable grocery bags when shopping I don't now, but I will start	Use reusable grocery bags when shopping No	Use reusable grocery bags when shopping N/A	Use reusable grocery bags when shopping
Refuse plastic, disposable straws at restaurants	Refuse plastic, disposable straws at restaurants Yes	Refuse plastic, disposable straws at restaurants I don't now, but I will start	Refuse plastic, disposable straws at restaurants No	Refuse plastic, disposable straws at restaurants N/A	Refuse plastic, disposable straws at restaurants
Buy secondhand goods at thrift & consignment shops	Buy secondhand goods at thrift & consignment shops Yes	Buy secondhand goods at thrift & consignment shops I don't now, but I will start	Buy secondhand goods at thrift & consignment shops No	Buy secondhand goods at thrift & consignment shops N/A	Buy secondhand goods at thrift & consignment shops
Recycle old, used electronic devices, & printer cartridges	Recycle old, used electronic devices, & printer cartridges Yes	Recycle old, used electronic devices, & printer cartridges I don't now, but I will start	Recycle old, used electronic devices, & printer cartridges No	Recycle old, used electronic devices, & printer cartridges N/A	Recycle old, used electronic devices, & printer cartridges
Participate in recycling programs in addition to the municipal recycling	Participate in recycling programs in addition to the municipal recycling Yes	Participate in recycling programs in addition to the municipal recycling I don't now, but I will start	Participate in recycling programs in addition to the municipal recycling No	Participate in recycling programs in addition to the municipal recycling N/A	Participate in recycling programs in addition to the municipal recycling
Buy groceries & household items in bulk packages to reduce packing & shipping materials	Buy groceries & household items in bulk packages to reduce packing & shipping materials Yes	Buy groceries & household items in bulk packages to reduce packing & shipping materials I don't now, but I will start	Buy groceries & household items in bulk packages to reduce packing & shipping materials No	Buy groceries & household items in bulk packages to reduce packing & shipping materials N/A	Buy groceries & household items in bulk packages to reduce packing & shipping materials
Reuse shipping materials when sending packages	Reuse shipping materials when sending packages Yes	Reuse shipping materials when sending packages I don't now, but I will start	Reuse shipping materials when sending packages No	Reuse shipping materials when sending packages N/A	Reuse shipping materials when sending packages
Re-purpose packaging for storage or other household uses	Re-purpose packaging for storage or other household uses Yes	Re-purpose packaging for storage or other household uses I don't now, but I will start	Re-purpose packaging for storage or other household uses No	Re-purpose packaging for storage or other household uses N/A	Re-purpose packaging for storage or other household uses
Pick up litter & dispose of properly	Pick up litter & dispose of properly Yes	Pick up litter & dispose of properly I don't now, but I will start	Pick up litter & dispose of properly No	Pick up litter & dispose of properly N/A	Pick up litter & dispose of properly
Do not release balloons into the environment; dispose of properly	Do not release balloons into the environment; dispose of properly Yes	Do not release balloons into the environment; dispose of properly I don't now, but I will start	Do not release balloons into the environment; dispose of properly No	Do not release balloons into the environment; dispose of properly N/A	Do not release balloons into the environment; dispose of properly
Other	Other Yes	Other I don't now, but I will start	Other No	Other N/A	Other

Other (please specify)

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* 11. CONSERVE ENERGY
Answer "YES" to the actions that you are consistently doing in your home and community.

	Yes	I don't now, but I will start	No	N/A
Install programmable thermostat	Install programmable thermostat Yes	Install programmable thermostat I don't now, but I will start	Install programmable thermostat No	Install programmable thermostat N/A	Install programmable thermostat
Purchase energy-efficient (Energy Star) appliances	Purchase energy-efficient (Energy Star) appliances Yes	Purchase energy-efficient (Energy Star) appliances I don't now, but I will start	Purchase energy-efficient (Energy Star) appliances No	Purchase energy-efficient (Energy Star) appliances N/A	Purchase energy-efficient (Energy Star) appliances
Run only full loads of laundry	Run only full loads of laundry Yes	Run only full loads of laundry I don't now, but I will start	Run only full loads of laundry No	Run only full loads of laundry N/A	Run only full loads of laundry
Turn off lights & appliances when not in use	Turn off lights & appliances when not in use Yes	Turn off lights & appliances when not in use I don't now, but I will start	Turn off lights & appliances when not in use No	Turn off lights & appliances when not in use N/A	Turn off lights & appliances when not in use
Unplug electronics when not in use	Unplug electronics when not in use Yes	Unplug electronics when not in use I don't now, but I will start	Unplug electronics when not in use No	Unplug electronics when not in use N/A	Unplug electronics when not in use
Replace incandescent bulbs with LED bulbs	Replace incandescent bulbs with LED bulbs Yes	Replace incandescent bulbs with LED bulbs I don't now, but I will start	Replace incandescent bulbs with LED bulbs No	Replace incandescent bulbs with LED bulbs N/A	Replace incandescent bulbs with LED bulbs
Open blinds/curtains to help with heating in winter; close to help with cooling in summer	Open blinds/curtains to help with heating in winter; close to help with cooling in summer Yes	Open blinds/curtains to help with heating in winter; close to help with cooling in summer I don't now, but I will start	Open blinds/curtains to help with heating in winter; close to help with cooling in summer No	Open blinds/curtains to help with heating in winter; close to help with cooling in summer N/A	Open blinds/curtains to help with heating in winter; close to help with cooling in summer
Drive fewer miles, eliminating unnecessary trips	Drive fewer miles, eliminating unnecessary trips Yes	Drive fewer miles, eliminating unnecessary trips I don't now, but I will start	Drive fewer miles, eliminating unnecessary trips No	Drive fewer miles, eliminating unnecessary trips N/A	Drive fewer miles, eliminating unnecessary trips

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* 12. PLANT FOR THE FUTURE
Answer "YES" to the actions that you are consistently doing in your home and community.

	Yes	I don't now, but I will start	No	N/A
Plant a tree	Plant a tree Yes	Plant a tree I don't now, but I will start	Plant a tree No	Plant a tree N/A	Plant a tree
Reduce lawn area by converting to planted, landscape beds	Reduce lawn area by converting to planted, landscape beds Yes	Reduce lawn area by converting to planted, landscape beds I don't now, but I will start	Reduce lawn area by converting to planted, landscape beds No	Reduce lawn area by converting to planted, landscape beds N/A	Reduce lawn area by converting to planted, landscape beds
Get soil test results before applying fertilizer & reduce, as able	Get soil test results before applying fertilizer & reduce, as able Yes	Get soil test results before applying fertilizer & reduce, as able I don't now, but I will start	Get soil test results before applying fertilizer & reduce, as able No	Get soil test results before applying fertilizer & reduce, as able N/A	Get soil test results before applying fertilizer & reduce, as able
Choose native plants for landscape	Choose native plants for landscape Yes	Choose native plants for landscape I don't now, but I will start	Choose native plants for landscape No	Choose native plants for landscape N/A	Choose native plants for landscape
Raise mower blades to 3-inches or higher to slow run-off & keep turf grass healthier	Raise mower blades to 3-inches or higher to slow run-off & keep turf grass healthier Yes	Raise mower blades to 3-inches or higher to slow run-off & keep turf grass healthier I don't now, but I will start	Raise mower blades to 3-inches or higher to slow run-off & keep turf grass healthier No	Raise mower blades to 3-inches or higher to slow run-off & keep turf grass healthier N/A	Raise mower blades to 3-inches or higher to slow run-off & keep turf grass healthier
Grow vegetables, herbs or fruits	Grow vegetables, herbs or fruits Yes	Grow vegetables, herbs or fruits I don't now, but I will start	Grow vegetables, herbs or fruits No	Grow vegetables, herbs or fruits N/A	Grow vegetables, herbs or fruits
Grow house plants to improve indoor air quality	Grow house plants to improve indoor air quality Yes	Grow house plants to improve indoor air quality I don't now, but I will start	Grow house plants to improve indoor air quality No	Grow house plants to improve indoor air quality N/A	Grow house plants to improve indoor air quality
Buy locally made or grown foods and products	Buy locally made or grown foods and products Yes	Buy locally made or grown foods and products I don't now, but I will start	Buy locally made or grown foods and products No	Buy locally made or grown foods and products N/A	Buy locally made or grown foods and products
Buy organically grown food products	Buy organically grown food products Yes	Buy organically grown food products I don't now, but I will start	Buy organically grown food products No	Buy organically grown food products N/A	Buy organically grown food products
Support restaurants & growers that locally source food items	Support restaurants & growers that locally source food items Yes	Support restaurants & growers that locally source food items I don't now, but I will start	Support restaurants & growers that locally source food items No	Support restaurants & growers that locally source food items N/A	Support restaurants & growers that locally source food items

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* 13. KEEP OUR WATERWAYS CLEAN
Answer "Yes" to actions you are consistently doing in your home and community.

	Yes	I don't now, but I will start	No	N/A
Pledge to Scoop the Poop	Pledge to Scoop the Poop Yes	Pledge to Scoop the Poop I don't now, but I will start	Pledge to Scoop the Poop No	Pledge to Scoop the Poop N/A	Pledge to Scoop the Poop
Display a Scoop the Poop sticker on your Virginia Beach trash can or in a building common area	Display a Scoop the Poop sticker on your Virginia Beach trash can or in a building common area Yes	Display a Scoop the Poop sticker on your Virginia Beach trash can or in a building common area I don't now, but I will start	Display a Scoop the Poop sticker on your Virginia Beach trash can or in a building common area No	Display a Scoop the Poop sticker on your Virginia Beach trash can or in a building common area N/A	Display a Scoop the Poop sticker on your Virginia Beach trash can or in a building common area
Install a BMP (rain barrel, infiltration trench, rain garden, etc.) to reduce storm water runoff from your property	Install a BMP (rain barrel, infiltration trench, rain garden, etc.) to reduce storm water runoff from your property Yes	Install a BMP (rain barrel, infiltration trench, rain garden, etc.) to reduce storm water runoff from your property I don't now, but I will start	Install a BMP (rain barrel, infiltration trench, rain garden, etc.) to reduce storm water runoff from your property No	Install a BMP (rain barrel, infiltration trench, rain garden, etc.) to reduce storm water runoff from your property N/A	Install a BMP (rain barrel, infiltration trench, rain garden, etc.) to reduce storm water runoff from your property
Sweep fertilizer off driveway, sidewalk & road	Sweep fertilizer off driveway, sidewalk & road Yes	Sweep fertilizer off driveway, sidewalk & road I don't now, but I will start	Sweep fertilizer off driveway, sidewalk & road No	Sweep fertilizer off driveway, sidewalk & road N/A	Sweep fertilizer off driveway, sidewalk & road
Keep gutter clear of dirt, leaves & debris so rain doesn't transport them to the storm drain	Keep gutter clear of dirt, leaves & debris so rain doesn't transport them to the storm drain Yes	Keep gutter clear of dirt, leaves & debris so rain doesn't transport them to the storm drain I don't now, but I will start	Keep gutter clear of dirt, leaves & debris so rain doesn't transport them to the storm drain No	Keep gutter clear of dirt, leaves & debris so rain doesn't transport them to the storm drain N/A	Keep gutter clear of dirt, leaves & debris so rain doesn't transport them to the storm drain
Wash car on lawn instead of driveway or use car wash that recycles water	Wash car on lawn instead of driveway or use car wash that recycles water Yes	Wash car on lawn instead of driveway or use car wash that recycles water I don't now, but I will start	Wash car on lawn instead of driveway or use car wash that recycles water No	Wash car on lawn instead of driveway or use car wash that recycles water N/A	Wash car on lawn instead of driveway or use car wash that recycles water
Use non-toxic, environmentally safe, biodegradable cleaning products	Use non-toxic, environmentally safe, biodegradable cleaning products Yes	Use non-toxic, environmentally safe, biodegradable cleaning products I don't now, but I will start	Use non-toxic, environmentally safe, biodegradable cleaning products No	Use non-toxic, environmentally safe, biodegradable cleaning products N/A	Use non-toxic, environmentally safe, biodegradable cleaning products
Do not feed ducks & geese	Do not feed ducks & geese Yes	Do not feed ducks & geese I don't now, but I will start	Do not feed ducks & geese No	Do not feed ducks & geese N/A	Do not feed ducks & geese
Keep grease can in kitchen for proper disposal	Keep grease can in kitchen for proper disposal Yes	Keep grease can in kitchen for proper disposal I don't now, but I will start	Keep grease can in kitchen for proper disposal No	Keep grease can in kitchen for proper disposal N/A	Keep grease can in kitchen for proper disposal
Reduce or eliminate use of garbage disposal	Reduce or eliminate use of garbage disposal Yes	Reduce or eliminate use of garbage disposal I don't now, but I will start	Reduce or eliminate use of garbage disposal No	Reduce or eliminate use of garbage disposal N/A	Reduce or eliminate use of garbage disposal
Turn off water in bathroom sink while brushing teeth	Turn off water in bathroom sink while brushing teeth Yes	Turn off water in bathroom sink while brushing teeth I don't now, but I will start	Turn off water in bathroom sink while brushing teeth No	Turn off water in bathroom sink while brushing teeth N/A	Turn off water in bathroom sink while brushing teeth
Take short showers to conserve water	Take short showers to conserve water Yes	Take short showers to conserve water I don't now, but I will start	Take short showers to conserve water No	Take short showers to conserve water N/A	Take short showers to conserve water
Run only full loads in the dishwasher	Run only full loads in the dishwasher Yes	Run only full loads in the dishwasher I don't now, but I will start	Run only full loads in the dishwasher No	Run only full loads in the dishwasher N/A	Run only full loads in the dishwasher
Install low-flow faucets and/or toilets	Install low-flow faucets and/or toilets Yes	Install low-flow faucets and/or toilets I don't now, but I will start	Install low-flow faucets and/or toilets No	Install low-flow faucets and/or toilets N/A	Install low-flow faucets and/or toilets

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* 14. TAKE ACTION
Answer "Yes" to the actions that you are doing consistently in and around your home and community.

	Yes	I don't now, but I will start	No	N/A
Donate to LRNow to keep Virginia Beach clean, green & resilient	Donate to LRNow to keep Virginia Beach clean, green & resilient Yes	Donate to LRNow to keep Virginia Beach clean, green & resilient I don't now, but I will start	Donate to LRNow to keep Virginia Beach clean, green & resilient No	Donate to LRNow to keep Virginia Beach clean, green & resilient N/A	Donate to LRNow to keep Virginia Beach clean, green & resilient
Support LRNow by registering your Kroger Rewards card	Support LRNow by registering your Kroger Rewards card Yes	Support LRNow by registering your Kroger Rewards card I don't now, but I will start	Support LRNow by registering your Kroger Rewards card No	Support LRNow by registering your Kroger Rewards card N/A	Support LRNow by registering your Kroger Rewards card
Shop AmazonSmile for Lynnhaven River Now	Shop AmazonSmile for Lynnhaven River Now Yes	Shop AmazonSmile for Lynnhaven River Now I don't now, but I will start	Shop AmazonSmile for Lynnhaven River Now No	Shop AmazonSmile for Lynnhaven River Now N/A	Shop AmazonSmile for Lynnhaven River Now
Help with LRNow a waterway cleanup or other community cleanup efforts	Help with LRNow a waterway cleanup or other community cleanup efforts Yes	Help with LRNow a waterway cleanup or other community cleanup efforts I don't now, but I will start	Help with LRNow a waterway cleanup or other community cleanup efforts No	Help with LRNow a waterway cleanup or other community cleanup efforts N/A	Help with LRNow a waterway cleanup or other community cleanup efforts
Communicate with an elected official about an environmental issue	Communicate with an elected official about an environmental issue Yes	Communicate with an elected official about an environmental issue I don't now, but I will start	Communicate with an elected official about an environmental issue No	Communicate with an elected official about an environmental issue N/A	Communicate with an elected official about an environmental issue
Display a LRNow Clean Boating sticker on your boat	Display a LRNow Clean Boating sticker on your boat Yes	Display a LRNow Clean Boating sticker on your boat I don't now, but I will start	Display a LRNow Clean Boating sticker on your boat No	Display a LRNow Clean Boating sticker on your boat N/A	Display a LRNow Clean Boating sticker on your boat

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* 15. There are many ways to "green" your home and be kind to our local waterways. Are there any other actions you are doing that are not listed elsewhere on your Pearl Home application?

If you were not able to check 15 items, LRNow hopes that you found some new actions to implement and will try again after you have worked these into your home routine.

If you did qualify with 15 or more actions, LRNow will coordinate with you on a time and place you can pick up your flag. Congratulations on becoming a Pearl Home!

Please continue below with your Sustainable Yards application. Choose the answer that most closely describes your practices. You are welcome to provide additional comments or explanations.

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* 16. Do you have flooding or channeling of stormwater on your property? If so, where?

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* 17. Do you have a septic system on your property? If so, where is your drain/leach field?

yes

Where

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* 18. Is there an oil tank on your property?

Yes

Unsure

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* 19. If yes, where is the oil tank located?

Above ground

Underground

Abandoned

N/A

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* 20. If yes, is the oil tank in use?

Yes

N/A

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* 21. If yes, is the oil tank full?

Yes

N/A

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* 22. Do you use a lawn service and/or hire an outside source for your lawn care needs?

Yes

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* 23. If yes, who do you currently use for your lawn service needs?

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* 24. Please check all that apply.

	Lawn	Garden (vegetable garden, flower bed, or potted plants)	Landscape Areas (shrubbery and trees)
I water on a regular schedule	I water on a regular schedule Lawn	I water on a regular schedule Garden (vegetable garden, flower bed, or potted plants)	I water on a regular schedule Landscape Areas (shrubbery and trees)
I water only when the weather is very hot and very dry	I water only when the weather is very hot and very dry Lawn	I water only when the weather is very hot and very dry Garden (vegetable garden, flower bed, or potted plants)	I water only when the weather is very hot and very dry Landscape Areas (shrubbery and trees)
I water when it has not rained for a couple of weeks	I water when it has not rained for a couple of weeks Lawn	I water when it has not rained for a couple of weeks Garden (vegetable garden, flower bed, or potted plants)	I water when it has not rained for a couple of weeks Landscape Areas (shrubbery and trees)
I water frequently, but for a short time	I water frequently, but for a short time Lawn	I water frequently, but for a short time Garden (vegetable garden, flower bed, or potted plants)	I water frequently, but for a short time Landscape Areas (shrubbery and trees)
I water frequently, but for a long time	I water frequently, but for a long time Lawn	I water frequently, but for a long time Garden (vegetable garden, flower bed, or potted plants)	I water frequently, but for a long time Landscape Areas (shrubbery and trees)
I use a sprinkler to water	I use a sprinkler to water Lawn	I use a sprinkler to water Garden (vegetable garden, flower bed, or potted plants)	I use a sprinkler to water Landscape Areas (shrubbery and trees)
I use a soaker hose to water	I use a soaker hose to water Lawn	I use a soaker hose to water Garden (vegetable garden, flower bed, or potted plants)	I use a soaker hose to water Landscape Areas (shrubbery and trees)
I water by hand with a garden hose	I water by hand with a garden hose Lawn	I water by hand with a garden hose Garden (vegetable garden, flower bed, or potted plants)	I water by hand with a garden hose Landscape Areas (shrubbery and trees)
I water by hand with a watering can	I water by hand with a watering can Lawn	I water by hand with a watering can Garden (vegetable garden, flower bed, or potted plants)	I water by hand with a watering can Landscape Areas (shrubbery and trees)
I have an automatic sprinkler system to water	I have an automatic sprinkler system to water Lawn	I have an automatic sprinkler system to water Garden (vegetable garden, flower bed, or potted plants)	I have an automatic sprinkler system to water Landscape Areas (shrubbery and trees)
I use tap to water	I use tap to water Lawn	I use tap to water Garden (vegetable garden, flower bed, or potted plants)	I use tap to water Landscape Areas (shrubbery and trees)
I use rain water from a barrel (other collection device) to water	I use rain water from a barrel (other collection device) to water Lawn	I use rain water from a barrel (other collection device) to water Garden (vegetable garden, flower bed, or potted plants)	I use rain water from a barrel (other collection device) to water Landscape Areas (shrubbery and trees)

Other (please specify)

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* 25. Please check all that apply.

	Lawn	Garden (vegetable garden, flower bed, or potted plants)	Landscaped Areas (shrubbery and trees)
I use chemical fertilizers if indicated by soil testing	I use chemical fertilizers if indicated by soil testing Lawn	I use chemical fertilizers if indicated by soil testing Garden (vegetable garden, flower bed, or potted plants)	I use chemical fertilizers if indicated by soil testing Landscaped Areas (shrubbery and trees)
I use chemical fertilizers on a regular basis	I use chemical fertilizers on a regular basis Lawn	I use chemical fertilizers on a regular basis Garden (vegetable garden, flower bed, or potted plants)	I use chemical fertilizers on a regular basis Landscaped Areas (shrubbery and trees)
I use "Weed & Feed" products	I use "Weed & Feed" products Lawn	I use "Weed & Feed" products Garden (vegetable garden, flower bed, or potted plants)	I use "Weed & Feed" products Landscaped Areas (shrubbery and trees)
I use chemical fertilizers for certain plants	I use chemical fertilizers for certain plants Lawn	I use chemical fertilizers for certain plants Garden (vegetable garden, flower bed, or potted plants)	I use chemical fertilizers for certain plants Landscaped Areas (shrubbery and trees)
I do not use fertilizers	I do not use fertilizers Lawn	I do not use fertilizers Garden (vegetable garden, flower bed, or potted plants)	I do not use fertilizers Landscaped Areas (shrubbery and trees)
I use only organic materials (manure, compost, leaves mowed in)	I use only organic materials (manure, compost, leaves mowed in) Lawn	I use only organic materials (manure, compost, leaves mowed in) Garden (vegetable garden, flower bed, or potted plants)	I use only organic materials (manure, compost, leaves mowed in) Landscaped Areas (shrubbery and trees)

Other (please specify)

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* 26. Do you (or your lawn service) take into account the weather forecast for rain in deciding when to apply fertilizers, pesticides or herbicides?

Yes

Unsure

N/A-These products are not used

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* 27. If you have a dog, how do you clean up their feces in your yard or on walks?

Bag it and put it in the trash

Bury it

Put it where it won't get stepped on

Leave it where it lands

I don't have a dog

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* 28. Urban landscapes have significant impact on water quality, either positive or negative. How willing are you, on a scale of 1 to 5 (5 being the most willing), to put some time and effort into watershed friendly landscaping?

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* 29. Please rank the following BMPs in order of which you are most to least interested in being considered for that BMP, a "1" being the BMP you are most interested, a "4" being the BMP in which you are least interested.

The copay for each BMP available through this program is:
$20 for the Pearl Lawn Plan with soil tests
$100 for the Rain barrel, Rain Garden or Infiltration Trench

Only a certain number of each BMP is available for each contract year.

Pearl Lawn Plan with soil tests

Rain barrel (You must have guttering on your home or have them installed by the installation date.)

Infiltration trench

Rain Garden

We will be contacting you about a date and time for your site visit soon. Thank you!

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* 1. Address

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* 2. Preferred method of contact:

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* 3. Are you the property owner?

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* 4. How did you hear about this program?

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* 5. Are you currently a Pearl Home?

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* 6. If you are representing your student's school as part of the Pearl School program, please provide the school's complete name below.

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* 7. Please note if you would prefer to receive a Pearl Home flag or magnet.

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* 8. My home is a(n)...

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* 9. Do you rent or own your home?

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* 10. REDUCE WASTEAnswer "YES" to the actions that you are consistently doing in your home and community.

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* 11. CONSERVE ENERGYAnswer "YES" to the actions that you are consistently doing in your home and community.

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* 12. PLANT FOR THE FUTUREAnswer "YES" to the actions that you are consistently doing in your home and community.

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* 13. KEEP OUR WATERWAYS CLEANAnswer "Yes" to actions you are consistently doing in your home and community.

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* 14. TAKE ACTIONAnswer "Yes" to the actions that you are doing consistently in and around your home and community.

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* 15. There are many ways to "green" your home and be kind to our local waterways. Are there any other actions you are doing that are not listed elsewhere on your Pearl Home application?

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* 16. Do you have flooding or channeling of stormwater on your property? If so, where?

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* 17. Do you have a septic system on your property? If so, where is your drain/leach field?

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* 18. Is there an oil tank on your property?

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* 19. If yes, where is the oil tank located?

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* 20. If yes, is the oil tank in use?

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* 21. If yes, is the oil tank full?

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* 22. Do you use a lawn service and/or hire an outside source for your lawn care needs?

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* 23. If yes, who do you currently use for your lawn service needs?

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* 24. Please check all that apply.

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* 25. Please check all that apply.

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* 26. Do you (or your lawn service) take into account the weather forecast for rain in deciding when to apply fertilizers, pesticides or herbicides?

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* 27. If you have a dog, how do you clean up their feces in your yard or on walks?

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* 28. Urban landscapes have significant impact on water quality, either positive or negative. How willing are you, on a scale of 1 to 5 (5 being the most willing), to put some time and effort into watershed friendly landscaping?

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* 10. REDUCE WASTE
Answer "YES" to the actions that you are consistently doing in your home and community.

* 11. CONSERVE ENERGY
Answer "YES" to the actions that you are consistently doing in your home and community.

* 12. PLANT FOR THE FUTURE
Answer "YES" to the actions that you are consistently doing in your home and community.

* 13. KEEP OUR WATERWAYS CLEAN
Answer "Yes" to actions you are consistently doing in your home and community.

* 14. TAKE ACTION
Answer "Yes" to the actions that you are doing consistently in and around your home and community.