Questionnaire Text

Questionnaire form view entire document: text image

7. This dwelling receives its water supply via:

[] 01 Pipes inside the dwelling
[] 02 Pipes outside the dwelling but on the property
[] 03 Public faucet
[] 04 Private well
[] 05 Public well
[] 06 Natural spring or falls
[] 07 River / stream / creek
[] 08 Truck / cart / tanks
[] 09 From another dwelling / neighbor / business
[] 10 Other

Questionnaire instructions view entire document: text image

Question 7: This dwelling receives its water supply via:

Read the options one by one and mark an "X" next to the one stated by the informant.

If there is more than one type of supply, mark the one that is used most.

The options "Pipes inside the dwelling" and "Pipes outside the dwelling but on the property" are ones that are connected to the public network.