COMMUNITY ENVIRONMENTAL HEALTH SURVEY Please help us better understand how the unique environmental health issues of the Gold Country impact you by completing this 30 question survey. Surveys are anonymous and results will be shared in aggregate form. Step 1 of 2 50% Informed Consent: The purpose of this survey is to better understand the unique environmental health impacts and priorities of residents of the Gold Country. This survey contributes to research being conducted by local non-profit The Sierra Fund as part of our Environmentally Healthy Communities Program. This survey is voluntary. Completing the online survey will take approximately 20 minutes. Your response will be confidential, and we do not collect identifying information such as your name, email address, or IP address. There are no foreseeable risks associated with this survey. There may be public health benefits associated with this survey by helping to identify unique exposure pathways and community health priorities. If you have questions about this survey or associated research please contact Alex Keeble-Toll, M.A., M.Sc., alex.keeble-toll@sierrafund.org. Clicking on the “Next” button below indicates that: • You have read the above information. • You voluntarily agree to complete the survey. Thank You. General QuestionsPlease select your answer from the dropdown menu. Leave question blank if you Decline to State.1. How long have you lived in Nevada County?*0-5 years5-10 years10-20 yearsMore than 20 years2. Do you rent or own your residence?*RentOwnOther3. Which local community do you reside in?*SmartsvillePenn ValleyRough and ReadyGrass ValleyNevada CityWashingtonCamptonvilleNorth San JuanDobbinsTahoe / TruckeeNone of the Above4. Do you have children under the age of 18 years?*YesNo5. What is your level of education?*No formal educationSome formal educationHigh School DiplomaSome CollegeTwo-Year Degree4-Year DegreeGraduate School Degree6. What is your (household) income level?*Less than $16,000$16,001-$38,000$38,001-$60,000$60,001-$83,000More than $83,000Issue Specific Questions7. Please rank the following environmental health issues 1-4 based on your level of concern.1 = most concerned about, 4 = least concerned about, use each value only onceMercury in Fish*Please enter a number from 1 to 4.Dusty Recreation and Heavy Metals*Please enter a number from 1 to 4.Water Quality and Access*Please enter a number from 1 to 4.Wildfire and Air Quality*Please enter a number from 1 to 4.MERCURY IN FISHPlease select your answer from the dropdown menu. Leave question blank if you Decline to State.8. Do you fish at local water bodies?*NeverOnce a YearOnce a MonthOnce a Week or More9. Do you eat the fish you catch at local waterbodies?*Not ApplicableNeverOnce a YearOnce a MonthOnce a Week or More10. Do your children (under 18 years) eat the fish you catch at local waterbodies?*Not ApplicableNeverOnce a YearOnce a MonthOnce a Week or More11. Which species of locally caught fish do you consume most often?*Not ApplicableBassRainbow TroutBrown TroutSunfishOtherDUSTY RECREATION AND HEAVY METALSPlease select your answers from the dropdown menu. Leave question blank if you Decline to State.12. Are you aware that Nevada County’s geology has naturally occurring heavy metals and minerals (lead, cadmium, arsenic, asbestos etc.)?*YesNoNot Sure13. Are you aware of any old mines in your neighborhood?*YesNoNot Sure14. Do you feel that you would be able to identify an abandoned mine based on land features (tunnels, shafts, piles of tailing etc.)?*YesNoNot Sure15. Do you work locally, in dusty conditions (landscaping, forestry, construction etc.)?*YesNo16. Do you use local trails for any of the following (select all that apply): Not Applicable Running/Hiking Mountain Biking Horseback Riding Off-Highway Vehicles WATER QUALITY AND ACCESS 17. Please rank the following water quality and water access issues 1-4 based on your level of concern.1 = most concerned about, 4 = least concerned about, use each value only onceLess Water Available in the Future*Please enter a number from 1 to 4.Contamination of Drinking Water*Please enter a number from 1 to 4.Flooding During Major Storms*Please enter a number from 1 to 4.Increased Cost of Water*Please enter a number from 1 to 4.18. Where do you get your water? (Select up to two.)* City Water NID Treated Water NID Raw Water Small Water Provider Private Residential Well Purchased Water (Refill Stations, Bottled Water) Vendor Delivery Spring Water (Bitney Springs etc.) Decline to State 19. Is the plumbing in your residence pre-1986?*YesNoNot Sure20. Have you had your water tested for lead?*YesNoNot Sure21. Does the amount of water in your well vary from year to year (static water level)?*Not ApplicableYesNoNot Sure22. Have you had your well tested in the last five years?*Not ApplicableYesNoNot SureWILDFIRE AND AIR QUALITYPlease select your answers from the dropdown menu. Leave question blank if you Decline to State.23. Please rank the following wildfire and air quality issues 1-4 based on your level of concern.1 = most concerned about, 4 = least concerned about, use each value only onceHealth-Related Impacts (respiratory, heart, other)*Please enter a number from 1 to 4.Loss of Property*Please enter a number from 1 to 4.Ability to Evacuate Safely*Please enter a number from 1 to 4.Lack of Adequate Homeowners or Renters Insurance*Please enter a number from 1 to 4.24. Do you or a family member you live with have a respiratory-related condition?*YesNo25. Do you check local air quality conditions during wildfire?*YesNo26. Do you have the ability to recirculate or filter indoor air when outdoor air quality is poor?*YesNo27. Do you have a job that requires you to work outdoors even if air quality is poor?*YesNo28. Do you have a woodstove in your home that you use more than once a week during cool weather?*YesNo29. Where do you get information about air quality and wildfire? (Select all that apply)* a. Local/Regional Television Station b. Local Newspaper c. YubaNet d. Social Media e. Air Resources Board f. Cal Fire g. Other If you selected "g. Other" please describe:30. Where do you get information about local environmental health issues? (Select all that apply)* a. Local/Regional Television Station b. Local Newspaper c. YubaNet d. Social Media e. Health Care Provider f. County Public Health Staff g. Other If you selected "g. Other" please describe:What is your age?*18-25 years26-35 years36-50 yearsOver 50 yearsPlease take a moment to note any additional comments and concerns you may have about environmental health in Nevada County and/or the Sierra Nevada region. Δ