Form 5800-049 Great Lakes AOC User Satisfaction Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (Renewal)

Great Lakes AOC User Satisfaction Survey

Great Lakes AOC Project Area Community Use and Benefits Intercept (Customer Satisfaction) Survey

OMB: 2030-0051

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OMB Control Number: 2030-0051

Expiration Date: 05/31/2024

This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2030-0051). Responses to this collection of information are voluntary. 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. The public reporting and recordkeeping burden for this collection of information is estimated to be 10 minutes per response. Send comments on the Agency’s need for this information, the accuracy of the provided burden estimates and any suggested methods for minimizing respondent burden to Director, Information Engagement Division, U.S. Environmental Protection Agency (2821T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.


Great Lakes Areas of Concern (AOCs)

Community Use and Benefits 


Welcome and thank you for your interest! Your participation in this survey will help us learn how people use [this site] and how to improve visitor experience. If you are at least 18 years old, would you mind sharing some of your insights and experiences about [this site] and your visit? The survey should only take about 10-15 minutes of your time. 


Your participation is voluntary and anonymous and we do not require you to disclose personal information.


The first few questions pertain to how you access the site and what you do at [the site] when you visit.


  1. Are you from [this area] or visiting?


1a. What is your zip code?


  1. How did you access [the site] today?

  • Walk-in

  • Bicycle

  • E-Bicycle

  • Vehicle

  • Boat

  • Other: ________


2a. How long did it take you to travel to [the site]?


  1. What does your typical visit to [this site] look like? In other words, what do you do and where do you go?


  1. How often do you visit [this site]?

  • Daily

  • More than once a week, less than daily

  • About once a week

  • About once a month

  • Less than once a month

  • This is my first time to [the site]


  1. How long do you generally spend at [this site] when you visit?

  • Less than one hour

  • Between one and two hours

  • More than two hours


  1. Do you fish at [this site]?

  • Yes

  • No


If yes to “Do you fish at [this site]?”

6a. Do you bring fish home to eat?

  • Yes

  • No


6b. How frequently do you eat fish from [this site]?

  • More than once a week

  • About once a week

  • About once a month

  • About once every two or three months

  • About once a year


6c. Phase I and Phase II of Restoration work: How do you expect fish quality to change after [remediation/restoration] work at [the site] is complete?

  • Improve greatly

  • Improve somewhat

  • Neither improve nor degrade

  • Degrade somewhat

  • Degrade greatly

  • I am unaware of restoration work happening at [this site]


6d. Phase III of Restoration work: How has fish quality changed since remediation/restoration work at [the site] was completed? *Include where work was completed prior to survey*

  • Improved greatly

  • Improved somewhat

  • Neither improved nor degraded

  • Degraded somewhat

  • Degraded greatly

  • I am unaware of restoration work happening at [this site]


  1. For which of the following reasons did you decide to visit [this site] today? [please select all that apply]

  • To recreate outdoors

  • To enjoy solitude/quietude

  • To enjoy the outdoors

  • To observe birds

  • To observe other wildlife

  • To Exercise

  • To Hike

  • To Socialize with friends or family

  • To Walk a pet

  • To Swim

  • To Fish

  • To Boat (motor or self-propelled)

  • Other ___________ (please explain)


  1. How, if at all, has this area changed over the last 10 years? [if applicable]


If you mentioned any changes

8a. How have these changes impacted your experience at [this site]?

  • Very positively

  • Somewhat positively

  • Neither positively or negatively

  • Somewhat negatively

  • Very negatively

  • Unsure


  1. What about [this site] would you like to see change?



The next few questions ask about your knowledge of, and participation in, any public discussions or stewardship of [the site]


  1. Are you aware of any opportunities for the public to discuss changes to [this site] (e.g., public meeting or outreach events; Note- this could be events in the past or future)?

  • Yes

  • No

  • I do not know


If yes, you are aware of opportunities for public discussion

10a. What are these opportunities (e.g., public advisory group meeting, interest group, neighborhood block party, etc.)?


10b. Did you participate in any of these public discussions?

  • Yes

  • No


If yes, you did participate in public discussion

10b1. What did you find useful and not useful about these discussions?


  1. Environmental stewardship is defined as environmental restoration, monitoring, education, conservation, advocacy, or taking care of a particular place or patch of land. To what extent have you engaged in “stewardship” at [this site]?


  • Very much

  • Somewhat

  • Not much

  • Not at all

  • I don’t know


If “very much” or “somewhat”

11a. What types of stewardship activities do you engage in around [this site]? [please select all that apply]

  • Educating the public

  • Conservation or preservation

  • Advocating for the environment

  • Restoring or transforming habitat

  • Monitoring environmental quality

  • Other __________ (please specify)


11b. Were any of these stewardship activities done with an interest group or other organization (e.g., HOA, nonprofit organization, government agency) that engages in environmental stewardship?

  • Yes

  • No


If yes

11b1. Please list the organizations or groups that completed stewardship activities with.


  1. To what extent do you believe that climate change will impact your ability to enjoy [this site]?


  • Very positively

  • Somewhat positively

  • Neither positively nor negatively (i.e., no change)

  • Somewhat negatively

  • Very negatively

  • Unsure

  • I do not believe in climate change


If any response other than “I do not believe in climate change”

12a. Please indicate your agreement with the following statement: The global climate is changing.

  • Disagree strongly

  • Disagree somewhat

  • Neither disagree nor agree

  • Agree somewhat

  • Agree strongly


12b. Please indicate your agreement with the following statement: The local [this site] climate is changing.

  • Disagree strongly

  • Disagree somewhat

  • Neither disagree nor agree

  • Agree somewhat

  • Agree strongly


Finally, we have a few questions about yourself.


  1. What is your gender?


  1. What is your approximate age?

  • Under 30

  • 31-40

  • 41-50

  • 51-60

  • Over 60


  1. What is your approximate household income?

  • Under $25,000

  • $25,000 - $49,999

  • $50,000 - $74,999

  • $75,000 - $99,999

  • Over $100,000


  1. Which of these categories best indicates your race? Answer only for yourself. [Please select all that apply]

  • American Indian or Alaska Native

  • Asian

  • Black or African American

  • Native Hawaiian or other Pacific Islander

  • White


  1. Are you Hispanic or Latino?

  • Yes

  • No


  1. What is the highest level of formal education you have completed? [Please select only one response.]

  • Less than high school graduate

  • High school graduate

  • Vocational/trade school certificate

  • Some college

  • Associate’s degree

  • Bachelor's degree

  • Master's degree or higher


Thank you for your time in taking this survey. Your responses will help us improve user experience. If you would like to learn more about [this site] and the work being done, please visit [updated Hub Site]

EPA Form: 5800-049

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AuthorJesse Engebretson
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