6700-018 Fishers Workshop PRE-Survey

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

FishersWG_PreSurvey

Lower Duwamish Waterway Superfund Site ICIAP "Fun to Catch, Toxic to Eat" Programmatic Evaluation Forms

OMB: 2030-0051

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7	-	Fishers	Workshop	PRE-Survey	(Multiple	Languages)
OMB	Control	Number:	2030-0051
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	(40	CFR).	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	15-30	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	the	Regulatory	Support	Division	Director,	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.

1.	Which	language	would	you	prefer	to	take	this	survey	in?
?	
¿en	qué	idioma	prefiere	tomar	esta	encuesta?	
Bạn	muốn	hoàn	thành	bảng	khảo	sát	của	mình	bằng	ngôn	ngữ	nào?	Hãy	chọn	ngôn	ngữ	mình
muốn.		
English
	/	Khmer
Español	/	Spanish
Tiếng	Việt	/	Vietnamese

Form	Number:		6700-018

7	-	Fishers	Workshop	PRE-Survey	(Multiple	Languages)
Fishing	Club	Pre-Survey	(English)
OMB	Control	Number:	2030-0051
*	2.	Participant	ID:	

*	3.	Which	team	are	you	with?	
	

GAL	Team

	

Khmer	Team

Vietnamese	Team

LARC	Team

4.	We	can	tell	with	our	eyes	if	a	fish	is	contaminated	with	toxic	chemicals.																															

					

	
True
False

5.	Eating	a	variety	of	seafood	from	different	places	can	help	minimize	your	exposure	to	toxic

chemicals.																																																																																				

	

True
False

6.	Because	I'm	an	adult,	it	is	safe	form	me	to	eat	crab,	mussels,	and	clams	from	the
Duwamish	River.																																																													

	
True
False

7.	Why	is	the	salmon	the	only	seafood	from	the	Duwamish	River	safe	to	eat?	Please	choose
one	answer.	

Because	the	color	of	the	meat	is	different	from	other	fish			

Because	salmon	spend	a	short	time	in	the	Duwamish	River			

Because	salmon	is	bigger	than	other	fish	caught	in	the	Duwamish	River					

8.	Which	group	can	be	harmed	the	most	by	the	toxic	chemicals	in	the	seafood	from	the
Duwamish	River?	

Pregnant/nursing	women	and	young	children				

Elderly	adults				

People	who	are	no	longer	having	children				

People	who	only	eat	seafood	from	supermarkets				

9.	It	is	legal	to	snag	salmon.	
True
False
Don't	know/not	sure

10.	It	is	legal	to	catch	salmon	that	are	tagged.	
True
False
Don't	know/not	sure

11.	What	do	you	need	to	go	fishing?	(Check	all	that	apply)	
Catch	record	card
Fishing	license	on-hand
Birth	certificate
Form	of	ID	(legal	ID,	driver's	license	or	passport)

12.	What	types	of	hooks	can	be	used	for	salmon	fishing	in	Washington?	
Barbed	hooks
Barbless	hooks

13.	How	many	crab	cages	can	each	person	deploy	while	fishing?	

14.	What	skills	or	topics	would	you	like	to	learn	more	about?	

*	15.	Please	enter	today's	date?	

Today's	date:

Date

MM/DD/YYYY

Form	Number:		6700-018

	

7	-	Fishers	Workshop	PRE-Survey	(Multiple	Languages)
Fishing	Club	Pre-Survey	Khmer
OMB	Control	Number:	2030-0051
*	16.	
Participant	ID:	

*	17.	

?

Which	team	are	you	with?	
	

GAL	Team

18.	

	

Khmer	Team

Vietnamese	Team

	

We	can	tell	with	our	eyes	if	a	fish	is	contaminated	with	toxic	chemicals.

							

	
True

False

19.	
Eating	a	variety	of	seafood	from	different	places	can	help	minimize	your	exposure	to	toxic
chemicals.	
True

False

20.	

	

	

	

	
	
			
Because	I'm	an	adult,	it	is	safe	form	me	to	eat	crab,	mussels,	and	clams	from	the	Duwamish
River.	

																																										

	

True

False

21.	
?	(

)

Why	is	the	salmon	the	only	seafood	from	the	Duwamish	River	safe	to	eat?	Please	choose	one
answer.	

Because	the	color	of	the	meat	is	different	from	other	fish				

	
Because	salmon	spend	a	short	time	in	the	Duwamish	River			

	
Because	salmon	is	bigger	than	other	fish	caught	in	the	Duwamish	River			

22.	
?
Which	group	can	be	harmed	the	most	by	the	toxic	chemicals	in	the	seafood	from	the
Duwamish	River?	

/
Pregnant/nursing	women	and	young	children	

	
Elderly	adults		

	
People	who	are	no	longer	having	children		

		
People	who	only	eat	seafood	from	supermarkets	

		

23.	

	

It	is	legal	to	snag	salmon.	
True

False
/
Don’t	know/not	sure

24.	
	
It	is	legal	to	catch	salmon	that	are	tagged.	
True

False
/
Don’t	know/not	sure

25.	

?	(	

)

What	do	you	need	to	go	fishing?	(Check	all	that	apply)	
Catch	record	card

Fishing	license	on-hand

Birth	certificate
	(
	
Form	of	ID	(legal	ID,	driver’s	license	or	passport)

26.	

	

	

	

)

?

What	types	of	hooks	can	be	used	for	salmon	fishing	in	Washington?	
Barbed	hooks

Barbless	hooks

27.	

?

How	many	crab	cages	can	each	person	deploy	while	fishing	?	

28.	
What	skills	or	topics	would	you	like	to	learn	more	about?	

?

*	29.	
Today's	date:	

		 	
Date

Date

MM/DD/YYYY

Form	Number:		6700-018

	

7	-	Fishers	Workshop	PRE-Survey	(Multiple	Languages)
Fishing	Club	Pre-Survey	Spanish
OMB	Control	Number:	2030-0051
*	30.	#ID	del	participante:
Participant	ID:	

*	31.	En	que	equipo	estas?
Which	team	are	you	with?	
	

GAL	Team

	

Khmer	Team

Vietnamese	Team

32.	Con	solo	verlo	nos	podemos	dar	cuenta	si	un	pescado	está	contaminado	con	sustancias
químicas	tóxicas.	
We	can	tell	with	our	eyes	if	a	fish	is	contaminated	with	toxic	chemicals.

	
Verdadero
True
Falso
False

33.	Comer	una	variedad	de	mariscos	de	diferentes	lugares	puede	ayudar	a	minimizar	su
exposición	a	sustancias	químicas	tóxicas.		
Eating	a	variety	of	seafood	from	different	places	can	help	minimize	your	exposure	to	toxic

chemicals.																						

	

Verdadero
True
Falso
False

34.	Como	soy	adulto,	puedo	comer	cangrejos,	mejillones	y	almejas	del	río	Duwamish	sin
peligro.
Because	I'm	an	adult,	it	is	safe	form	me	to	eat	crab,	mussels,	and	clams	from	the	Duwamish
River.	

																																																					

	

Verdadero
True
Falso
False

35.	¿Por	qué	el	salmón	es	el	único	marisco	del	río	Duwamish	seguro	para	comer?	(Elija	todas
las	que	aplican)
Why	is	the	salmon	the	only	seafood	from	the	Duwamish	River	safe	to	eat?	(Please	choose	one
answer.)	

Porque	el	color	de	la	carne	es	diferente	al	de	otros	peces.
Because	the	color	of	the	meat	is	different	from	other	fish.	

Porque	el	salmón	pasa	poco	tiempo	en	el	Río	Duwamish.
Because	salmon	spend	a	short	time	in	the	Duwamish	River.		

Porque	el	salmón	es	más	grande	que	otros	peces	capturados	en	el	río.
Because	salmon	is	bigger	than	other	fish	caught	in	the	Duwamish	River.		

36.	¿Qué	grupo	puede	resultar	más	perjudicado	por	las	sustancias	químicas	toxicas	en	los
mariscos	del	río	Duwamish?
Which	group	can	be	harmed	the	most	by	the	toxic	chemicals	in	the	seafood	from	the
Duwamish	River?	

Mujeres	embarazadas/lactantes	y	niños	pequeños	
Pregnant/nursing	women	and	young	children			

Adultos	mayores		
Elderly	adults			

Personas	que	ya	no	están	teniendo	hijos		
People	who	are	no	longer	having	children		

Personas	que	comen	mariscos	de	los	supermercados		
People	who	only	eat	seafood	from	supermarkets		

37.	Es	legal	enganchar	el	salmón.
It	is	legal	to	snag	salmon.	
Verdadero
True
Falso
False
No	sé	/	no	estoy	seguro
Don't	know/not	sure

38.	Es	legal	pescar	salmones	que	están	marcados.
It	is	legal	to	catch	salmon	that	are	tagged.	
Verdadero
True
Falso
False
No	sé	/	no	estoy	seguro
Don't	know/	not	sure

39.	¿Qué	necesitas	para	ir	a	pescar?	(Elija	todas	las	que	aplican)
What	do	you	need	to	go	fishing?	(Check	all	that	apply)	
Tarjeta	de	registro	de	captura
Catch	record	card
Licencia	de	pesca	a	mano
Fishing	license	on-hand
Certificado	de	nacimiento
Birth	certificate
Alguna	forma	de	Identificación	(ID	legal,	licencia	de	conducir	o	pasaporte)
Form	of	ID	(legal	ID,	driver’s	license	or	passport)

40.	¿Qué	tipos	de	anzuelos	se	pueden	utilizar	para	la	pesca	del	salmón	en	Washington?
What	types	of	hooks	can	be	used	for	salmon	fishing	in	Washington?	
Anzuelos	de	púas
Barbed	hooks
Anzuelos	sin	púas
Barbless	hooks

41.	¿Cuántas	trampas	para	cangrejos	puede	usar	cada	persona	mientras	pesca?
How	many	crab	cages	can	each	person	deploy	while	fishing?	

42.	¿Sobre	qué	habilidades	o	temas	le	gustaría	aprender	más?
What	skills	or	topics	would	you	like	to	learn	more	about?	

*	43.	Fecha
Today's	date	

Fecha	/	Date

Date

MM/DD/YYYY

Form	Number:		6700-018

	

7	-	Fishers	Workshop	PRE-Survey	(Multiple	Languages)
Fishing	Club	Pre-Survey	Vietnamese
OMB	Control	Number:	2030-0051
*	44.	số	ID	của	quý	vị
PARTICIPANT	ID	#	

*	45.	Bạn	đang	ở	với	đội	nào?
Which	team	are	you	with?	
	

GAL	Team

	

Khmer	Team

Vietnamese	Team

46.	Bằng	mắt	thường	chúng	ta	có	thể	biết	được	cá	có	bị	nhiễm	hóa	chất	độc	hại	hay	không.
We	can	tell	with	our	eyes	if	a	fish	is	contaminated	with	toxic	chemicals.

	
Đúng
True
Sai
False

47.	Ăn	nhiều	loại	hải	sản	từ	những	nơi	khác	nhau	có	thể	giúp	giảm	thiểu	việc	quý	vị	tiếp	xúc
với	các	hóa	chất	độc	hại.
Eating	a	variety	of	seafood	from	different	places	can	help	minimize	your	exposure	to	toxic
chemicals.																																								

																																																																													

	

Đúng	
True
Sai
False

48.	Vì	tôi	là	người	lớn	nên	tôi	có	thể	an	toàn	ăn	cua,	sò	và	ốc	hến	ở	sông	Duwamish
Because	I'm	an	adult,	it	is	safe	form	me	to	eat	crab,	mussels,	and	clams	from	the	Duwamish
River.	

																																																					

	

Đúng
True
Sai
False

49.	Tại	sao	cá	hồi	là	hải	sản	duy	nhất	ở	sông	Duwamish	là	an	toàn	để	ăn?	(kiểm	tra	tất	cả	các
câu	phù	hợp)
Why	is	the	salmon	the	only	seafood	from	the	Duwamish	River	safe	to	eat?	(Please	choose	one
answer.)	

Vì	màu	sắc	của	thịt	khác	với	các	loại	cá	khác		
Because	the	color	of	the	meat	is	different	from	other	fish		

Vì	cá	hồi	sống	một	thời	gian	ngắn	ở	sông	Duwamish		
Because	salmon	spend	a	short	time	in	the	Duwamish	River		

Vì	cá	hồi	lớn	hơn	các	loại	cá	khác	được	đánh	bắt	ở	sông		
Because	salmon	is	bigger	than	other	fish	caught	in	the	Duwamish	River		

50.	Nhóm	nào	có	thể	bị	tác	hại	nhiều	nhất	bởi	chất	độc	hóa	học	trong	hải	sản	từ	sông
Duwamish?
Which	group	can	be	harmed	the	most	by	the	toxic	chemicals	in	the	seafood	from	the
Duwamish	River?	

Phụ	nữ	có	thai	/	cho	con	bú	&	trẻ	nhỏ		
Pregnant/nursing	women	and	young	children

Người	lớn	tuổi			
Elderly	adults

Những	người	không	còn	con	cái		
People	who	are	no	longer	having	children

Những	người	ăn	hải	sản	từ	siêu	thị		
People	who	only	eat	seafood	from	supermarkets

51.	Đánh	lừa	cá	hồi	là	hợp	pháp.	
It	is	legal	to	snag	salmon.	
Đúng	
True
Sai	
False
Không	biết	/	không	chắc	
Don't	know/not	sure

52.	Đánh	bắt	cá	hồi	được	gắn	thẻ	là	hợp	pháp.	
It	is	legal	to	catch	salmon	that	are	tagged.	
Đúng	
True
Sai	
False
Không	biết	/	không	chắc	
Don't	know/	not	sure

53.	Quý	vị	cần	gì	để	đi	câu	cá?	(chọn	tất	cả	các	áp	dụng)	
What	do	you	need	to	go	fishing?	(choose	all	that	apply)	
Thẻ	Ghi	Bắt	Cá	
Catch	record	card
Giấy	phép	đánh	cá	có	trong	tay	
Fishing	license	on-hand
Giấy	khai	sinh	
Birth	certificate
Hình	thức	ID	(ID	hợp	pháp,	bằng	lái	xe	hoặc	hộ	chiếu)	
Form	of	ID	(legal	ID,	driver's	license	or	passport)

54.	Những	loại	lưỡi	câu	nào	có	thể	được	sử	dụng	để	câu	cá	hồi	ở	tiểu	bang	Washington?	
What	types	of	hooks	can	be	used	for	salmon	fishing	in	Washington?	
lưỡi	câu	có	móc	ngạnh	
Barbed	hooks
lưỡi	câu	không	có	móc	ngạnh	
Barbless	hooks

55.	Mỗi	một	người	có	thể	thả	bao	nhiêu	lồng	cua	khi	câu	cua?	
How	many	crab	cages	can	each	person	deploy	while	fishing?	

56.	Bạn	muốn	học	thêm	về	những	kỹ	năng	hoặc	chủ	đề	nào?	
What	skills	or	topics	would	you	like	to	learn	more	about?	

*	57.	Ngày	hôm	nay	
Today's	date	

Ngày	/	Date

Date

MM/DD/YYYY

Form	Number:		6700-018

	


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