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Geo SBA Questionnaire

Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.

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1

How old are you?

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2

What is your gender?

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3

Occupational Status?

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4

How long have you lived on Campden Park?

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5

How serious is the pollution problem in Campden Park?

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6

How aware are you of the pollution issue in Campden Park?

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7

What types of pollution do you believe are most prevalent in Campden Park?

Select one or more answers
8

How would you rate the overall environment quality of Campden Park?

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9

Do you believe that local authorities are doing enough to combat pollution in Campden Park?

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10

How do you think pollution from the industry impacts the environment around Campden Park?

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11

What measures are being taken to reduce the effects of pollution in the area?

12

On a scale of 1-5 how concerned are you about pollution in your community?

13

Have you or anyone in your household experienced health issues that you believe are related to pollution? If yes, Please specify the health issues.

14

Have you you noticed anychanges in local wildlife or plantlife? If yes, What kind?

15

Would you be interested in participating on community discussion or initiates related to pollution in Campden Park?

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