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pdf2 - Moms and Caregivers Mini Quiz (Multiple Languages)
OMB Control Number: 2030-0051
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(OMB Control No. 2030-0051). Responses to this collection of information are voluntary (40 CFR). An agency may
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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: 6700-016
2 - Moms and Caregivers Mini Quiz (Multiple Languages)
Moms and Caregivers Workshop Knowledge Quiz (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 for 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. Please enter today's date?
Today's date:
Date
MM/DD/YYYY
Form Number: 6700-016
2 - Moms and Caregivers Mini Quiz (Multiple Languages)
Moms and Caregivers Workshop Knowledge Quiz - Khmer
OMB Control Number: 2030-0051
* 10.
Participant ID:
* 11.
?
Which team are you with?
GAL Team
12.
Khmer Team
Vietnamese Team
We can tell with our eyes if a fish is contaminated with toxic chemicals.
True
False
13.
Eating a variety of seafood from different places can help minimize your exposure to toxic
chemicals.
True
False
14.
Because I'm an adult, it is safe form me to eat crab, mussels, and clams from the Duwamish
River.
True
False
15.
? (
)
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
16.
?
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
* 17.
Today's date:
/ Date
Date
MM/DD/YYYY
Form Number: 6700-016
2 - Moms and Caregivers Mini Quiz (Multiple Languages)
Moms and Caregivers Workshop Knowledge Quiz - Spanish
OMB Control Number: 2030-0051
* 18. # ID del participante:
Participant ID:
* 19. En que equipo estas?
Which team are you with?
GAL Team
Khmer Team
Vietnamese Team
20. 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
21. 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
22. 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
23. ¿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
24. ¿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
* 25. Today's date
Fecha
Fecha / Date
Date
MM/DD/YYYY
Form Number: 6700-016
2 - Moms and Caregivers Mini Quiz (Multiple Languages)
Moms and Caregivers Workshop Knowledge Quiz - Vietnamese
OMB Control Number: 2030-0051
* 26. số ID của quý vị
PARTICIPANT ID #
* 27. Bạn đang ở với đội nào?
Which team are you with?
GAL Team
Khmer Team
Vietnamese Team
28. 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
29. 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
30. 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
31. 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
32. 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
* 33. Ngày hôm nay
Today's date
Ngày / Date
Date
MM/DD/YYYY
Form Number: 6700-016
| File Type | application/pdf |
| File Modified | 0000-00-00 |
| File Created | 2024-04-08 |