Section Instructions:  Please answer the following questions to assist us in determining the focus of our stormwater education and training efforts. 1   Within the past year, do you recall reading, seeing, or hearing messages about stormwater pollution (e.g. "Only Rain in the Drain," "Be the Solution to Water Pollution")? Yes No 2   Do you think any of the following potential sources of pollution pose a threat to our environment? No Threat Minimal Threat Somewhat Threatening Serious Threat Very Serious Threat Automobile Oil/Fluids Chemical Waste from Industry Chemical Waste from Households Construction Activities Fertilizers Herbicides/Pesticides Pet Waste Runoff from Streets/Parking Lots Sewage Trash/Illegal Dumping Yard Waste 3   Do you engage in any of the following practices? (check all that apply) Pick up after your pet and dispose of waste in the trash Compost or use use green waste bins to dispose of leaves, grass clippings, or other yard wastes instead of sweeping, blowing, or hosing them into the street Dispose of household chemicals properly (by following package directions or taking to a household hazardous waste collection ceter) Wash your vehicle at a commercial car wash Have your oil changed by a professional or recycle used oil at an oil collection center Limit the use of pesticides, herbicides, and fertilizers 4   In which jurisdiction do you live? Avondale Chandler Fountain Hills Gilbert Glendale Goodyear Mesa Peoria Phoenix Scottsdale Surprise Tempe Unincorporated Maricopa County Other   5   Do you have any comments or suggestions for the Stormwater Quality Program?

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