Water Survey - Rates & Quality Water Survey - Rates & Quality Question Title * 1. How do you pay for water? I pay a monthly rate I pay a quarterly rate I pay an annual rate I do not know Other (please specify) Question Title * 2. What do you pay for these services per month? $0-25 $25-50 $50-75 $75-100 $100-200 Greater than $200 Cable Cable $0-25 Cable $25-50 Cable $50-75 Cable $75-100 Cable $100-200 Cable Greater than $200 Phone & Internet Phone & Internet $0-25 Phone & Internet $25-50 Phone & Internet $50-75 Phone & Internet $75-100 Phone & Internet $100-200 Phone & Internet Greater than $200 Electric Electric $0-25 Electric $25-50 Electric $50-75 Electric $75-100 Electric $100-200 Electric Greater than $200 Gas Gas $0-25 Gas $25-50 Gas $50-75 Gas $75-100 Gas $100-200 Gas Greater than $200 Question Title * 3. Which of these statements do you agree with? My household pays too much for water My household consumes lots of bottled water My household uses lots of water Question Title * 4. Where do you live? Apartment / condominium Town house / single family home Other (please specify) Question Title * 5. Do you own your home? Yes No Question Title * 6. Select all the statements that you believe to be true There is a global water crisis Climate change is affecting water supplies Water is a right, not a privilege Tap (potable) water is as clean as bottled water Question Title * 7. What do you think the price of potable / tap water should be based on? Flat rate based on average household income Flat rate based on the number of people living in a home Flat rate based on the value of the home Flat rate based on the size of the home Variable rate based on the quantity of water used Other (please specify) Question Title * 8. How much water does your household use daily? Less than 10 gallons per day 10-50 gals per day 50 - 100 gals per day 100 - 200 gals per day Question Title * 9. How much bottled water does your household use daily? Less than 10 liters per day 10-50 liters per day 50 - 100 liters per day 100 - 200 liters per day We do not use bottled water Question Title * 10. How many people currently live in your household? Question Title * 11. What is the source of water for your household? A private water well A publicly owned treatment works I don't know Question Title * 12. Select all that apply I know the source of my drinking water I consider myself very knowledgeable about water and sewage treatment I pay too much for water and sewage services Water treatment is cheap I work in the water/wastewater industry Water and sewer rates are used to pay for water treatment Water and sewer rates are used to raise money for non water related projects Question Title * 13. Rate the service of your current water supply Excellent Very Good Average Poor Very poor Quality Quality Excellent Quality Very Good Quality Average Quality Poor Quality Very poor Color Color Excellent Color Very Good Color Average Color Poor Color Very poor Taste Taste Excellent Taste Very Good Taste Average Taste Poor Taste Very poor Smell Smell Excellent Smell Very Good Smell Average Smell Poor Smell Very poor Pressure Pressure Excellent Pressure Very Good Pressure Average Pressure Poor Pressure Very poor Question Title * 14. What does your household use these water sources for? (check all that apply) Tap water Bottled water Bathing Bathing Tap water Bathing Bottled water Drinking Drinking Tap water Drinking Bottled water Cooking Cooking Tap water Cooking Bottled water Car washing Car washing Tap water Car washing Bottled water Laundry Laundry Tap water Laundry Bottled water Lawn care (watering the garden/lawn) Lawn care (watering the garden/lawn) Tap water Lawn care (watering the garden/lawn) Bottled water Question Title * 15. What is the maximum price you are willing to pay per thousand gallons of tap water? Less than 10 cents Up to 50 cents Up to one dollar Up to 5 dollars Up to 10 dollars Up to 20 dollars Question Title * 16. What is your gender? Female Male Question Title * 17. What is the highest level of education you have completed? Less than high school High school Associates/College degree and higher Question Title * 18. How does your water tariff compare with what you pay for other utilities (e.g., electricity, cable) Too high Average / just right Too low I don't know Next