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2. By completing this survey by June 30th you will be entered to win a $100 Visa gift card.
4. First Name*
5. Last Name*
7. Street Address*
8. Phone Number*
   (area code) XXX-XXXX
10. Email*
12. 1. Do you have a basement?*

    1. YES
    2. NO

    If YES, please continue to #2. If NO, you are done! Scroll to end and submit.
14. 2. Do you have a sump pump?

    1. YES
    2. NO
    3. I don't know

    If YES, please continue to #3. If NO, you are done! Scroll to end and submit.
15. A sump pump is a small pump installed in a sump pit, at the lowest part of a basement.
    
17. 3. Is this a single family, owner occupied residence?

    1. YES
    2. NO

    If YES, please continue to #4. If NO, you are done! Scroll to end and submit.
19. 4. Do you have a backwater valve?

    1. YES
    2. NO
    3. I don't know

    Continue to #5
20. A backwater valve is installed in the private sewer lateral (the line that connects your home to the city sewer).
    
22. 5. What is the approximate age of your home?

    1. 0-40 years
    2. 41-80 years
    3. Older than 80 years
24. 6. Are you willing to participate* in a study to measure the amount of water pumped by your sump pump?

    1. YES
    2. NO

    *Participation in the study entails allowing a City employee to install a small electric counter (called a totalizer meter) on your sump pump. The totalizer will measure the amount of time the sump pump is running during the summer and fall months. The total gallons of water pumped by your sump will then be calculated. Near the end of October a City employee will retrieve meter. Installing and retrieving the counter will be scheduled to fit your availability. See images of the counter and as it is installed below.
26. Electric Counter
    
27. Electric counter as installed in a homeowner basement.
    
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29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit Submit and Print

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