2013-04-symptomatology_of_a_gas_field_Geralyn_McCarron

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Symptomatology of a gas field - An independent health survey in the Tara rural residential estates and environs Part 1- Environmental details of each household CSG HEALTH QUESTIONNAIRE Name Survey number Date Address Occupants Appendix A Name age Relationship How long have you lived on the property? House structure Single Double storey wooden Brick/ slab other Size of property Power source Mains electricity Solar Generator Other Page 2 of 8
Symptomatology of a gas field - An independent health survey in the Tara rural residential estates and environs Name survey no Water supply Town Trucked Bottled Rainwater tanks Dam Bore River/cree k other Appendix A Drinkin g cookin g Water storage, type of tanks How is water treated before use? Home environment Washin g dishes Washin g clothes Bathin g Vegetabl e garden Domesti c animals Air conditioner Air purifier Central heating(gas) (oil) Gas stove Electric stove Fireplace Wood stove humidifier Have you recently acquired new furniture, carpet or refinished furniture? Yes, no Are pesticides or herbicides (bug or weed killers; flea and tick sprays, collars powders or shampoos) used in your home or garden, or on pets? Yes, no To your knowledge, when did CSG activity start? othe r Page 3 of 8
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APPENDIX C - PERCEIVED IMPACTS ON A
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1 Public servants tasked with appro
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2013-04-symptomatology_of_a_gas_field_Geralyn_McCarron

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