IABC/ Greater Newark HUD Tenants Housing Survey
InJustice@BrickCity  is working in conjunction with HUD Tenants Association to Assess Newark's Housing stock - -
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1.) What is your name? *
2) Respondent's complete home address and apartment# (canvasser you can complete this yourself while on site) *
3) What is your phone number? *
4.) Did you received a lead-safe certificate from your landlord when you leased your apartment? *
5) If you have received a lead-safe certificate from your landlord, do you currently have a copy?
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6)Was your building subjected to a Lead Line replacement? *
7) Please indicate if you want to get your water and/or home tested for Lead? *
8) Have you had your water tested (2017-2024)?
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9.) If  yes what was the result? *
10) Have your children ever been tested for lead?- *
11) If your children have tested for lead, what was the result? .
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12) Have you ever called code-enforcement? *
13) If you called code-enforcement, did code-enforcement resolve your issue? *
14)Does your building currently  have any of the following issues?. *
Required
14a) Do areas of your home of building have a musty or moldy smell?
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14b)  Is mold or mildew in your bathroom appearing more frequently and/or to a greater extent? *
14c) Has your home or building suffered from water damage in the last two years? *
14d)  Do you notice condensation on the inside of your windows or glass sliding doors? *
15) Can we follow up with you? *
16) Best way to contact you,
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17) How long have you lived in Newark, NJ?
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Do you have a complaint or statement?:
Open ended 
Canvassers name?
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