Please share your insight to help inform the planning of a countywide Air Quality Summit.
Questions? Contact info@sustainablesolano.org

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* 1. Name

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* 2. Email

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* 3. Telephone number

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* 4. Preferred method of contact

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* 5. Which city do you live in? (if you live in unincorporated Solano, which city is the closest to you)?

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* 6. What ZIP code do you live in?

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* 7. Which language is primarily used in your household?

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* 8. How familiar are you with air quality issues in your city on a scale of 1-5?

1 -  Not at all 3 - Somewhat 5 - Very familiar
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i We adjusted the number you entered based on the slider’s scale.

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* 9. Do you think there is a problem with air quality in your city on a scale of 1 - 5?

1 -  No issue with air quality locally 3 - There are some issues with air quality locally 5 - There are major issues with air quality locally
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i We adjusted the number you entered based on the slider’s scale.

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* 10. How often does poor air quality impact your daily life?

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* 11. Do you or anyone in your household have a condition that is worsened by poor air quality (e.g. asthma, cardiovascular disease, etc.)?

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* 12. What sources of air pollution in your city concern you? (Choose all that apply)

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* 13. What are you most interested in learning about at a countywide Air Quality Summit (or future event)?

The questions below are optional, but we hope you will take the time to answer them to help better inform planning for the Air Quality Summit and our air quality work in the county.

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* 14. Is there anything else you’d like to see at a countywide Air Quality Summit?

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* 15. We would like to learn more about community needs and resources that could be leveraged to address air quality concerns. Are you a member of, aware of, or involved with any community groups, local initiatives or community-led projects that you would recommend we connect with? Please list them if so.

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* 16. Which actions are the highest priority?

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* 17. How do you want to be involved in improving your city’s air quality? (select all that apply)

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