Impacted Resident Stakeholder Survey
We want to hear your preferences for safe drinking water solutions in the Kaweah area. The Kaweah Water Foundation (KWF) is developing solutions for local communities who may not have safe drinking water due to nitrates. If you are located within the boundary of the KWF, please complete this Impacted Resident Stakeholder Survey to voice your concerns and provide your valuable input for short-term and long-term safe drinking water.
Which area of the Kaweah Management Zone do you reside in?
(Optional to provide name of community or nearest intersection)
How many people live in your household?
Are you the owner or tenant?
Clear selection
Do you know if your tap water comes from a public water system or a private domestic well?
Clear selection
Do you know if your tap water is impacted by nitrates or other constituents?
Clear selection
If yes, how long have you known?
If yes, which constituents impact your tap water?
If yes, are you drinking bottle water instead?
Clear selection
If yes, are you using any type of water treatment?
Clear selection
If your drinking water comes from a public water system, what is the name of the public water system?
If you currently receive bottle water delivery through an existing program, what is the name of the program providing you water?
If you currently buy bottled water, how many miles from your residence do you travel to get bottled water?
If you currently buy bottled water, how many gallons do you purchase each month?
If your water comes from a private domestic well, do you know if the drinking water well was previously tested for nitrates?
Clear selection
If yes, what was the reported result?
If no, why have you not had it tested?
Clear selection
If no, would you like to have your drinking water tested?
Clear selection
If you would like to have your domestic well water tested, please include your name, telephone number and/or email address.
Do you have concerns regarding your drinking water quality?
Clear selection
If yes, what are they?
How would you describe your water quality? (e.g. taste, color, odor)
If your drinking water is unsafe, please rank your preference for free short-term replacement water. (1 is top preference, 4 is low preference)
1
2
3
4
Filling station (kiosk)
Bottle water available for pick up
Bottled water delivery
Home treatment system
For filling station (kiosk) and/or bottled water pick up, how many miles from your home would you be willing to travel for short-term replacement water?
Clear selection
Do you have recommendations regarding long-term safe drinking water supplies?
Clear selection
If yes, what are they?
Please share any other pertinent information the Kaweah Water Foundation should be aware of or take into consideration while addressing short-term and long-term safe drinking water solutions in your area/community.
What are the best ways for the KWF to communicate with you? (select up to 3)
What are the best ways for you to communicate with the KWF? (select up to 3)
First & Last Name
Preferred Language:
Clear selection
Please share your email address if you would like to receive updates from the Kaweah Water Foundation about replacement drinking water.
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