Participant Questionnaire 
D a te: _ 
Participant's Name:_ 
Address: _____ 
Pre-wipes / / HE PA Dropped Off / / Post wipes 
1. What do you think of this program? 
2. Was the information provided easy to understand? If not please comrpent. 
3. How did the vacuum perform for you? Please comment about any problems you 
had if any, 
4. Where did you use the vacuum? (floors, sills, wells, etc) Please specify. 
5. How often did you vacuum with the HEPA vacuum? (More than once?) 
8. Which attachment did you find most useful? 
7. Would you recommend this program to others? Why or Why not? 
8. Do you have access to the internet? Give out the web address, (syrempact.lead- 
safe. com) 
Please provide any additional comments - use back if necessary: 
LEAD SAFE, LLC 
2410 East Lake Road * Skaneatsles, New York 13152 • (316) 685*0864 Fax (316) 686-0940 
http://wwww.lssd-sifs.com 
Evaluating Syracuse’s Lead 
Dust Project 
7 5 
