Questionnaire Text

Questionnaire form view entire document: text image

[Questions 3 to 10 were asked of private households]

4. Water supply

A. Source

[] 1 Well, cistern (aljibe) or spring
[] 2 River, stream
[] 3 Public system
[] 4 Other (specify) ____

Questionnaire instructions view entire document: text image

II. Information about the dwelling

4. Water Service:

a) Source: Mark the corresponding box, which is the source that provides water to the inhabitants of the dwelling.

* Public network: this is marked when the occupants of the dwelling get water from a public network, such as, for example, corposana.

When the source is not any of the three first indicated on the form, mark "other" and specify which it is. For example: water delivery truck.

4. Water service
A. Source

[] 1 Well, pipe or spring
[] 2 River, creek
[] 3 Public network
[] 4 Other (specify) ____