1. Education Outreach Program Development to Help Citizens and Community

This survey is part of the efforts of the Groundwater Guardians and the Water Research Center, to help educate and inform the community. The Keystone Clean Water Team is a 501(c)(3) non-profit, volunteer, environmental education organization which provides homeowners with information on private wells, water quality and quantity, and septic systems. We are dedicated to protecting private well owners from illnesses caused by our drinking water. We advance good groundwater stewardship by raising awareness on a variety of groundwater issues that affects everyone with a private water supply.

We can help you get your water tested at the lab of your choice and explain the test resultsThe survey will not be published and all information is confidential. Part of this survey will be used to create a new booklet that helps educate private well owners and policy makers in our community. This survey is not funded by any outside company or organization and solely funded by Mr. Brian Oram the current manager for the Groundwater Guardian Organization and Director of the Research Center. If you have questions about this survey please email - bfenviro@ptd.net or call (570) 335-1947.

For participating in this survey - you will receive a free refrigerator magnet and a copy of our new booklet that it is NOW available. Thanks for your assistance.

Please visit - http://www.carbonwaters.org and http://www.pacleanwater.org

* 1. Please provide general contact information. This question requires an answer to only select questions (name, city, state, zip, and county) -you will not be contacted unless you ask.

* 3. Do you have a private water source or a community water source?

* 4. Has baseline testing been conducted?

* 5. Has Marcellus Shale Gas Development started?

* 6. If baseline testing has not been conducted, do you need assistance in selecting testing parameters, conducting testing, and interpreting results?

* 7. If baseline testing was conducted, would you be willing to release this data to a confidential community or citizen based groundwater and surfacewater database - Assuming the database only included the testing results, county, and zip code?

* 8. Are you a member of a watershed group, environmental group or organization, or other citizen based organization?

* 9. Would you or your community group, municipality, or other citizen based organization be interested in hosting an education program related to protecting and maintaining surfacewater and groundwater quality and quantity?

* 10. Please provide any addition comments or questions.

* 11. Are you interested in low cost informational water testing or developing a local citizen based monitoring program to screen surfacewater and groundwater quality?

* 12. Do you or your organizations have questions about Marcellus Shale Development - If so, what are they?

* 13. Is your organization or you concerned about the following?

  Not Concerned/ Not a Problem Somewhat Concerned Moderately Concerned Concerned Very Concern Extremely Concerned
Lack of Private Well Construction Standards
Uncontrolled Stormwater Runoff from Commercial Lots
Poorly Sited or Old Septic Systems
Quality of Streams for Recreation
Impacts of Domestic Wastewater Treatment Plants
Stormwater Runoff from Residential Lots

* 14. Do you know what Sourcewater Protection is?

* 15. If protecting groundwater required the development of a local ordinance that controlled well location and construction only, but added a cost of $ 600 to $ 1000.00 to a new well - Would you Support?

* 16. If a local ordinance was established and the ordinance required the well be tested annually. Would you support, if the cost of the annual testing was less than $ 50.00?

* 17. We are currently developing a research project. The project will be unfunded by outside sources and only funded by BF. Environmental Consultants Inc. The project will look and compare the levels of radon gas in private wells in Marcellus Shale and similar regions. We are looking for about 200 volunteer private well owners in PA to participate. What you would have to provide-
1. A copy of your baseline testing results that have been completed.
2. Complete an informational form
3. Be available to collect samples during the week.
4. There will be no charge for radon testing and you will release the use of the data to B.F. Environmental Consultants Inc for educational purposes.
You will receive a copy of all testing results and all your personal information is confidential.
Would you be interested in participating in this research?

* 18. Are you concerned about Abandon Oil and Gas Wells?

Thank you for your time and we appreciate your feedback - To say thank you for your time, please go to this website to download a Free Booklet on Water Quality (1st edition). We will mail you a hardcopy of the second addition- visit our website - http://www.water-research.net

If you want - you can complete this survey by mail - Download the form at our website and mail to Keystone Clean Water Team 15 Hillcrest Drive, Dallas, PA 18612
http://www.carbonwaters.org  http://www.pacleanwater.org