Whirinaki and Esk Valley water survey

Question Title

* 1. Name

Question Title

* 2. Address

Question Title

* 3. Mobile

Question Title

* 4. Email

Question Title

* 5. In the last eight weeks have you had discoloured water?

Yes

If yes, how many times?

Question Title

* 6. If 10 is black and 1 is clear, what number is your water on a bad day?

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

* 7. If 10 is black and 1 is clear, what number is your water on a good day?

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

* 8. Do you have a household water treatment system?

Yes

If yes, was the treatment system installed before or after Cyclone Gabrielle? Please list type e.g. filter, water softener etc.

Question Title

* 9. I’d like to sign up for SMS text alerts for advance warning of water use changes

Yes - please ensure you have entered your mobile number above.

Question Title

* 10. I’d like to sign up for an email database for future community updates

Yes - please ensure you have entered your email address above.

Question Title

* 11. Have you been receiving our letter box water updates?

Yes

Whirinaki and Esk Valley water survey

Question Title

* 1. Name

Question Title

* 2. Address

Question Title

* 3. Mobile

Question Title

* 4. Email

Question Title

* 5. In the last eight weeks have you had discoloured water?

Question Title

* 6. If 10 is black and 1 is clear, what number is your water on a bad day?

Question Title

* 7. If 10 is black and 1 is clear, what number is your water on a good day?

Question Title

* 8. Do you have a household water treatment system?

Question Title

* 9. I’d like to sign up for SMS text alerts for advance warning of water use changes

Question Title

* 10. I’d like to sign up for an email database for future community updates

Question Title

* 11. Have you been receiving our letter box water updates?

Question Title

* 12. Questions or comments