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2018 Keep Our Waters Clean Questionnaire and Pledge

Page One

Thank you for taking your time to answer the questions below. Your input will help us work toward improving environmental education in California.

Please let us know the date and location where you received the boater kit and questionnaire. *This question is required.

Date:
Location Name & City:

1. How long have you been boating? *This question is required.

	months, or
	years

2. What is your 5-digit home zip code? *This question is required. This question requires a valid number format.

3. What type of boat(s) do you currently own? *This question is required.

4. What type of toilet is on your boat? *This question is required.

5. If you use a mobile pump-out service, please check the following box and skip to Question 6.

Not Applicable

In the past year, when using a sewage pump-out station, how often...(Please check one box per question.)

Space Cell	Never	Rarely	Half the Time	Most Often	Always
Is it broken?	Never	Rarely	Half the Time	Most Often	Always
Is it closed?	Never	Rarely	Half the Time	Most Often	Always
Do you wait in line?	Never	Rarely	Half the Time	Most Often	Always
Are you unable to find one?	Never	Rarely	Half the Time	Most Often	Always

Or:

I NEVER use the installed toilet on my boat.

6. Did you know this logo represents a location where you can recycle used motor oil? *This question is required.

Image for Question 6.

7. Did you know this logo represents a location where you can safely pump-out your boat sewage?

Image for question 7.

8. Which of the following may happen to those who discharge untreated boat sewage within the 3-mile territorial limit? *This question is required.

9. Which of the following may happen to those who discharge fuel, oil, oily wastes and hazardous substances into or upon navigable waters of the U.S.? *This question is required.

10. The use of soaps or other dispersing agents to dissipate and/or mask oil on the water is: *This question is required.

11. It is illegal to dump boat treated waste in which of the following locations? (check all that apply)

*This question is required.

Marina or yacht harbors
No Discharge Zones
Freshwater lakes, freshwater reservoirs or freshwater impoundments
Rivers that don't support interstate traffic
None of the above
Don't Know