Baseline Questionaire
Please fill out qestionaire to help evalute LAN effectiveness. Based on EnAct Baseline and Results Surveys.
Solid Waste:
Transportation:
| Make | Year | Model | Miles Driven/Yr | MPG city | MPG highway | |
|---|---|---|---|---|---|---|
| Vehicle 1 | ||||||
| Vehicle 2 | ||||||
| Vehicle 3 | ||||||
| Vehicle 4 |
| Household Member | Vehicle Miles/Wk |
|---|---|
| 1 alone | |
| 2 alone | |
| 3 alone | |
| 4 alone | |
| Household carpool | |
| Total Vehicle Miles |
Other Modes of Transportation
Limousine
Taxi
USTAS bus
Work Shuttle bus
Energy:
Water:
Yard:
Is most of your yard a lawn? ___ yes ___ no
Is most of your yard trees and shrubs? ___ yes ___ no
What type of lawn mower do you or lawn service use? ___ gas ___ electric ___ manual push mower
Number of native plant species in your yard ____.
Household Information: How many people are in your household? ______
How many of these people are children (under 18 yrs. old)? _____
How long have you lived in Central Susquehanna Region? ____
How long have you lived at your current address? ____
How many neighbors (within 2 blocks) do you know? (i.e. say more than "hello") ___
What type of housing do you live in? single family ___ apt. ____ condo ___
multifamily ( 6 units or fewer) ___
Do you rent or own? ___
Thank you for completing this survey. Click here to send to LAN.
