Water Refilling Station

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1. How many are you in the household?
Specify: ____________________

2. How much is your family monthly income?
a. Php 5,000 – 10, 000
b. Php 11,000 – 15,000
c. Php 16,000 – 20,000
d. Other, specify:_______
3. What is your primary source of drinking water?
a. Home purifier
b. faucet
c. other, specify: _______
4. How many gallons of water does your household consume for drinking in a day? a. 1 – 5 gallons
b. 6 – 10 gallons
c. 10 – 15 gallons
d. Other, specify:______
5. How much will it cost you per 5 gallons of drinking water? a. Php 30 – 35
b. Php 36 – 40
c. Php 41 – 45
d. Php 46 – 50
6. Do you consider water refilling station as one of your source of drinking water? Yes__
No__
7. How often do you buy drinking water in water refilling station? a. Everyday
b. Every other day
c. Weekly
d. Other, specify:______
8. Are you satisfied with the products and services of the current water refilling station in your barangay? a. Very satisfied
b. Satisfied
c. Dissatisfied
d. Very dissatisfied

9. What are your usual complains in your resent water supplier (refilling stations)? a. High price
b. Late delivery
c. Untidy gallons
d. Other, specify:______
10. If a new water refilling station would be put up in your vicinity, would you be interested in patronizing it? a. Yes
b. No
c. Maybe
11. What do you consider first when buying in water refilling station? a. Business name
b. Location
c. Price
d. Quality
e. Services
f. Other, specify:______
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