Dynamic Survey

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SURVEY FORM

What's in your Well Water?

1. Is city supply available to you?

	Yes
	No

2. Do you use city supply only?

	Yes
	No

3. What is your main source of water supply?

	City
	Well

4. Are you satisfied with city supply?

	Yes
	No

5. Are you satisfied with well supply?

	Yes
	No

6. Do you use both city & well supply?

	Yes
	No

7. Do you think your well water is safe?

	Yes
	No

8. Do you frequently treat your well water?

	Yes
	No

9. Have you ever had your well water tested? Against bacteria?

	Yes
	No

10. Do you treat your well water regularly?

	Yes
	No

11. Are you aware of the reverse osmosis technology? Which will be used by the Corporation?

	Yes
	No

12. Would you be willing to use reverse osmosis Water when it becomes available?

	Yes
	No

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