Questionnaire Text

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5. Water service for the dwelling


B. Source of water

[] 1 Public system
[] 2 Well or water wheel
[] 3 ____ Other source (specify)

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Question No. 5--Dwelling's Water Service


A. Water Supply

1) Has piped water inside the dwelling: Mark box 1 if the dwelling receives water through a faucet in the kitchen, bathroom, or any other place within the dwelling.

2) Has piped water outside the dwelling: In this case, the faucet is outside the dwelling and you should mark box 2, also noting the approximate distance from the faucet to the dwelling.

3) Doesn't have piped water supply: You should mark box 3 if the dwelling has a piped water supply neither inside nor outside.