State of California

Department of Toxic Substances Control


 


ITT CANNON HUMBOLDT STREET PROPERTY

 

COMMUNITY SURVEY QUESTIONNAIRE


 

 


1) How long have you lived or worked in the area?

 

__   0‑5 years                  __   6‑12 years      __   13‑20 years     __   21 or more years

 

2) Prior to reading the letter, were you aware of the site's condition?

__   YES                __   NO

 

If YES, where did you acquire your prior knowledge about the site?

 

__   Newspapers    __   Neighbors       __   Relatives

__   Other (Please specify source, especially if you have information about the early history of the site. Attach additional pages as needed):                                                                                                                                                                                        

                                                                                                                                                                                                                                                                           

 

3) What is your current level of interest in this site?

 

__   None     __   Low to moderate        __   Moderate to high

 

4) Do you have any specific concerns about this site or project? If so, please describe:

                                                                                                                                     

                                                                                                                                                                                                                                                                           

                                                                                                                                     

 

5) Have you had any contact with local, state or other officials regarding this site?

__   YES àà If YES, please describe:                                                                            

__   NO                                                                                                                          

 

6) Have you had any contact with the owners of this site or those responsible for its cleanup? 

__   YES àà If YES, please describe:                                                                            

          __   NO                                                                                                                          

 

àà à  Please continue on the backside ààà

7) Are you interested in receiving information about the investigation and future work?

__   YES àà If YES, what is the best way?           __   Fact Sheets or Letters

__   NO                                                                      __   Community Meetings

                                                                                 __   Other  (please specify)

 

8) What languages are spoken in your community?

 

If you named a language besides English, do you feel that future communication to community

members regarding this site should be written in this language?           __   YES         __   NO

 

9) Can you suggest any other person or groups that might be interested in receiving information about this site or the work proposed for it?

                                                                                                                                     

                                                                                                                                     

 

 

10) Please let us know of any other comments or questions.

 

11) If you are interested in being added or taken off the mailing list for information related to ITT Cannon Humboldt Street Property site, please check the appropriate line and return to the

address below.

__   Please place me on the mailing list for future materials on this site.

__   Please remove my name from the mailing list.       

 

Name:                                                                                                                                                 Place

stamp

                                                                                                                                                            here

Address:                                                                                                                                 

 

 

Telephone No.:                                                                                                                       

 

Please mail this document to:

 

Department of Toxic Substances Control

5796 Corporate Avenue

Cypress, CA 90630

Attn: Leticia Hernandez, Public Participation Specialist

 

 

 

Please fold the letter with the address showing, place stamp on the right‑hand side and staple or seal, thank you.