Corps of Engineers Civil Works Questionnaires Generic Clearance

FACILITY ENVIRONMENTAL CLEANUP

(Personal Interview)

OMB 0710-0001

Expires: 30 September 2012

The public report burden for this information collection is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this data collection, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Executive Services Directorate, Information Management Division, and the Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, D.C. 20503, Attn.: Desk Officer for U.S. Army Corps of Engineers. Respondents should be aware that notwithstanding any other provision of law, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Please DO NOT RETURN your completed form to either of these offices.

FACILITY ENVIRONMENTAL CONCERNS

1. Do you rent or own property near the SUBJECT FACILITY? (Check Blank))

____No; if no, go to 2.

____Yes; if yes, go to 1a.

____Not Applicable; go to 2.

1a. Have you had any problems with this property that you think are attributable to the operations at the SUBJECT FACILITY? (Check)

____No; if no, go to 2.

____Yes; if yes, go to 1b.

1b. What sort of problems have you had?

______ ____________________________________________________________

______________ __________________________________________________

2. Do you use water from wells or playas in or around the plant? (Check)

____No; if no, go to 3.

____Yes; if yes, go to 2a.

____Not Applicable, go to 3.

2a. Do you use water from: (Check)

____Wells ____Playas ____Both

2b. Do you use the water for: (Check)

____Drinking ____Irrigation ____Both

2c. Have you had any problems with your water that you think are attributable to the operations at the SUBJECT FACILITY?

____No; if no, go to 3.

____Yes; if yes, go to 2d.

2d. What sort of problems have you had?

______ ____________________________________________________________

______________ __________________________________________________

3. Have you had any contacts with government officials regarding environmental issues related to operation of the plant? (Check)

____No; if no, go to 5.

____Yes; if yes, go to 3a.

3a. What government agency(s) did you contact?

(List each one and date of contact, if known.)

_________________________________________________________

3b. Overall, how would you characterize your feelings about the responsiveness of government officials to your concerns?

Would you say they were: not responsive, somewhat responsive, or very responsive? (Check)

____Not Responsive

____Somewhat Responsive

____Very Responsive

3c. What sort of problems, if any, have you had in getting government officials to respond to your concerns?

_____________________________________________________

4. What are your concerns, if any, about the operation of the SUBJECT FACILITY?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

5. Have you participated in any activities (meetings, telephone calls, letter writing, or gatherings) concerning the SUBJECT FACILITY? (Check)

____No; if no, go to 6.

____Yes; if yes, go to 5a.

5a. What activities have you participated in?

______________________________

5b. Were any of these activities government sponsored? (Check)

____ No.

____ Yes

6. Would you like to be kept informed of future activities at this site? (Check)

____ No.

____ Yes, if yes, please give name and address

_______________________________________________

_______________________________________________

The next two questions deal with the way information can be distributed to the public and the way the public can express any concerns regarding operation of the plant.

7. Based on your needs for information about the SUBJECT FACILITY, what is the most desirable method for getting information to the public?

______________________________________________________________

______________________________________________________________

8. What do you feel are the most effective ways you can communicate your concerns to government officials about the SUBJECT FACILITY?

_____________________________________________________________________

_____________________________________________________________________

9. What kind of information do you desire in terms of environmental issues at the SUBJECT FACILITY? (Check One Blank)

____ None

____ Non-technical summary of the issues

____ Technical summarization of the issues

____ Detailed Technical Documents

____ Other (please list)______________________________________

10. How frequently would you like to be updated on environmental issues at the SUBJECT FACILITY? (Check One Blank)

____Monthly

____Quarterly

____Semi-Annually

____Yearly

____Other (please list)______________________________________

11. Is there anything else you would like to add about how information is communicated in regards to environmental issues at the SUBJECT FACILITY? (Check)

____ No

____ Yes (If yes, please list below:)

5