Beach Environmental Assessment, Communication and Health Program

 
Name (Optional):  

Email (Optional):   

Do you want to receive emails about the BEACH Program?   Yes No

Phone number (Optional): 

Do you want to be contacted regarding this survey? Yes No

Location where you recreate:
Name of Public Park: 

Name of beach or location where you enter the water: 

Near by city or town: 

What did you do at this site?
kayak
Harvest shellfish
Scuba dive
Surf
Swim
Wade
Other: 


How much time do you spend in the water per day while at this site?
30 minutes
30 minutes - 1 hour
1 - 2 hours
2-3 hours
3-4 hours
4-6 hours
6 hours or more

How many times a year do you visit this site? 

Are you concerned about potential pollution problems at this site? Yes No

Comments




Thank you for taking the time to respond to this survey.