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* 1. Where do you live?

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* 2. On a scale of 1 to 5, please rate which communication tools work best to give you information about your community questions and concerns with 5 as the best tool and 1 as the least preferred tool.

  1 (least preferred tool) 2 3 4 5 (best tool)
Mailed Fact Sheets
Small group meetings
Emails
Text Messages
Web site
Twitter
Community meetings
Internet Videos
Information through your Schools
Information through your Church
Information posted in public areas
Workshops / Open Houses
Information through Radio stations
Information through Newspapers

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* 3. On a scale of 1 to 5 (with 1 being least and 5 being most) please rate your level of concern with the following:

  1 (least preferred tool) 2 3 4 5 (most preferred tool)
Pesticide use
Hydraulic fracking for oil
Groundwater quality
Truck traffic
Landfill
Public health issues

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* 4. Would you like an interview, to give us more detailed responses to these questions? If yes, please give us your name, telephone number and / or email address.

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* 5. Is there a person or organization that you would suggest we interview? If so, please give us their name, phone number or email address.

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* 6. Do you have any other comments or suggestions?

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* 7. Have you used the Department of Toxic Substances Control (DTSC) web site for any information? (www.envirostor.dtsc.ca.gov/public/hwmp_profile_report.asp?global_id=CAD980675276 )

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