Questionnaire Text

Questionnaire form view entire document: text image

4. The water supply of the dwelling

[] 1 Piped water from water works in the dwelling
[] 2 Piped water from the well in the court-yard is in the dwelling
[] 3 Piped water from water works is only in the court-yard
[] 4 You use the water of the well in the court-yard
[] 5 From another place (e.g. from the well outside the plot, from a spring); specify ____

5. Is there hot running water in the dwelling?

[] 0 No
[] 1 Yes; from a long-distance pipe-line
[] 2 Yes; from a central boiler
[] 3 Yes; from a gas boiler
[] 4 Yes; from an electric boiler
[] 5 Yes; from a bathroom stove
[] In another way; specify it ____

6. Is there a flush toilet?

[] 0 No
[] 1 Yes, inside the dwelling
[] 2 Yes, but outside the dwelling

7. Is there a sewage disposal from the dwelling?

[] 0 No
[] 1 Yes; in a public sewer
[] 2 Yes; through a house sewer into a closed sewage reservoir
[] 3 Yes; into desiccators (cesspool)
[] 4 Yes; to another place

8. Do you use gas in the dwelling?

[] 0 No
[] 1 Yes; piped gas
[] 2 Yes; bottle (propane-butane) gas

9. How do you heat the dwelling?

[] 1 District (block) heating, with thermal water
[] 2 With individual central boiler heating several dwellings
[] 3 Central heating (separate central heating for one flat) for one dwelling or family house
[] 4 Premises heating (with gas convector, stove, oil-stove, water-heating stove, oil- radiator, heat-radiator etc.)
[] 0 There is no possibility for heating

15 Is there a telephone in the dwelling?

[] 0 No
[] 1 Yes

19. Do you find satisfactory the present housing conditions of the family?

Maximum [of] three replies may be underlined [indicated].

[] 0 Yes
[] 1 No, because it has few rooms or its floor-space is small
[] 2 No, because the floor-space is large
[] 3 No, because it is badly designed
[] 4 No, because its comfort is not satisfactory
[] 5 No, because the costs of its maintenance are high
[] 6 No, because the environment of the dwelling is noisy
[] 7 No, because the air of the environment is vitiated
[] 8 No, because the environment of the dwelling is not satisfactory in another respect
[] 9 No, because you have no separate dwelling

Questions 18 and 19 should be answered by the first and -- if any -- the second family living in the dwelling.

Questionnaire instructions view entire document: text image

4. Water supply of the dwelling

In case the dwelling is supplied with water from different sources the answer representing the more convenient source will be signed. The answer "the water from the public well I the street (5)" can be signed if community piped water is available there. In case the water is supplied from a dig or drilled well or the water is distributed in plastic bags the answer is "other source".

5. Hot water supply of the dwelling

Any kind of hot water supply, even a boiler used for washing-up is accepted. In case the hot water is supplied from several sources the one used for bath should be marked.

6. Availability of flush-toilet

The answer "yes, within the dwelling (1)" will be accepted provided the dwelling is supplied with running water in the dwelling and is connected to a sewage facility.

7. Connection to the sewage facility

The answer "yes, local facility" can be marked provided the waste water is channeled into a closed desiccators. At least one of the answers should be marked.

9. Heating of the dwelling

If the heating of the dwelling different methods are applied the one used in the rooms should be marked.