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| w |
Do
you live next to/near an industrial
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plant,
commercial business, dump
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site,
or nonresidential property?
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| w |
Which
of the following do you have
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in
your home? Air conditioner; air
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purifier; central heating (gas or oil);
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Gas
stove; electric stove; fireplace;
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Wood
stove; humidifier
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Have
you recently acquired new
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furniture
or carpet, refinished
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furniture
or remodeled your home?
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Have
you weatherized your home
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recently?
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Approximately
what year was your
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home
built?
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| w |
Are
pesticides or herbicides (bug
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or
week killers, flea and tick
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sprays,
collars, powders, or
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shampoos)
used in your home or
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garden
or on pets?
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| w |
Do
you (or any household
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member)
have a hobby or a
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craft?
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| w |
Do
you work on your car?
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Have
you ever changed your
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residence
because of a health
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problem?
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Does
your drinking water come
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from
a private will, city water
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supply,
or grocery store?
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