Nonresponse Bias Study Questionnaire

OMB Control Number 2090-0028
Expires 6/30/2015

The Future of the
Chesapeake Bay
A Brief Survey

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The Clean Water Act authorizes collection of this information. All responses will be kept confidential to the extent permitted by law.
Response to this survey is voluntary and no action will be taken against you if you choose not to take part. The public reporting burden
for this form is estimated to average 5 minutes per response. Send comments regarding the burden estimate or any other aspect of
this form to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW,
Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the survey materials to this address.

The Chesapeake Bay Watershed
This survey asks you about two types of water bodies in the Chesapeake Bay Watershed — the
Chesapeake Bay itself and Lakes in the Watershed. Each has different characteristics and
potential water quality concerns.

The Watershed
Is shaded in light grey on
this map.
It includes about 4,200
freshwater lakes.
Water draining from lands
in the Watershed enters
rivers and streams and
eventually the Chesapeake
Bay.

The Chesapeake Bay
Is an estuary where freshwater mixes with
saltwater from the ocean. It is the largest
estuary in North America and the third
largest in the world.

As shown in dark grey on this map, the
Bay includes portions of the 50 rivers that
flow into it, for example:



The James River up to Richmond, VA



The Potomac River up to
Washington, DC

Please use this definition of the
Chesapeake Bay when answering
questions on this survey.

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1. Before receiving this survey, had you heard of the Chesapeake Bay?

□ Yes

□ No

□ Don’t know

2. On average, how often do you see the following water bodies? (Please check
ONLY ONE box in each row.)
Never

Less than
once a month

More than
once a month

Don’t Know

Chesapeake Bay:

□

□

□

□

Watershed Lakes:

□

□

□

□

3. In the last five years, have you participated in recreational activities
(including swimming, boating, fishing, or viewing nature) at the…
(Please check ONLY ONE box in each row.)
Chesapeake Bay:

□ Yes

□ No

□ Don’t know

Watershed Lakes:

□ Yes

□ No

□ Don’t know

4. Before taking this survey, were you aware that too much nutrients or sediment
can degrade water quality?

□ Yes

□ No

□ Don’t know

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5. Please rate how much you agree or disagree with the following statements.
(Please circle one number for each statement.)
Strongly
Disagree

Strongly
Agree

Don’t
Know

It is important to improve waters in the
Chesapeake Bay Watershed, no matter
how high the costs.

1

2

3

4

5

DK

I am against any more regulations and
government spending.

1

2

3

4

5

DK

My household should not have to pay any
amount for programs to improve Bay
Waters and Watershed Lakes.

1

2

3

4

5

DK

It is often difficult for me to find time to
take surveys.

1

2

3

4

5

DK

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Questions about you and your household
Finally, we would like to ask a few questions about you and your household.
Your answers will not be saved or stored in a way that can be associated with your
name or address. You will not be contacted about your responses or this survey.
16. What is your sex?

□Male

□Female

17. What is your age? _____ years old
18. How many children under age 18 are living in your home? _____children
19. Have you or any member of your family ever worked in any of the
following industries or jobs?

□Agriculture
□Tour guide for fishing
□Commercial fishing
□Environmental non-profit group
□No one in my family ever worked in these industries

20. In 2012, what was your total pre-tax household income, including all
earners in your household?

□Under $25,000
□$25,000-$49,999
□$50,000-$74,999
□$75,000-$99,000

□$100,000-$149,999
□$150,000-$199,999
□$200,000 or more

21. Are you of Hispanic, Latino, or Spanish origin?

□ Yes

□ No

22. What is your race? (Select one or more.)

□ American Indian or Alaska Native
□ Asian
□ Black or African American
□ White
□ Native Hawaiian or Other Pacific Islander

23. What is the highest degree or level of school you have completed?

□ Elementary or high school, but no high school diploma or GED
□ High school diploma, GED, or other high school completion
□ Some college credit, no degree
□ Associate’s Degree (for example: AA, AS)
□ Bachelor’s Degree (for example: BA, BS)
□ Master’s degree, professional degree, or doctorate degree
(for example, MA, MSW, MD, DDS, JD, PhD, EdD)

Thank you very much for your help.
Please mail this completed survey back to us in the postage-paid return envelope provided.
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Thanks again for completing this survey
If you have any questions please call XXX-XXX-XXXX
or email [email protected].

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