County-Wide Septic System Survey
Is your property served by a septic system?
Yes
No
Don't Know
When was the last time you had your septic tank(s) pumped?
1-3 Years
3-5 Years
> 5 Years
Never
Don't Know
Would you like to know more about septic system ownership and maintenance?
Yes
No
Don't Care
Optional Information
Full Name
First Name
Last Name
Full Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Submit this Form to the Durham County Department of Public Health
Should be Empty: