LOMA LINDA UNIVERSITY MARSHALL TSLAND EXYVIZCNMENTAL HEALTH SURVEY ATOLL NAME Island Name Surveyor's Name Aid's Name Source of Informacion Population No. { ] Census (date } { ] Other, specify No. of dwelling units No. of people/unit HOUSING Main wall construction. [ ] cement (block) { ] wood { }] mac [ ] cement { J] mat ( ] other, specify Main £loor construction. { ] tile { ] stone { ] earth Main reof construction. { ] wood { ] other, specify [{ ] metal General state of repair. [ ] good [ ] thatch [ ] other, spectty [ ] fair [ ] peor Comments TOILET FACILITIES Type { ] pic privtes ( [ ] with water-~seal ( ] witheut pacer-seal) f ] inside flush toilet { ] other, specify Condition { ] adequate [ ] odor [ ] fltes { ] suraice Fontaminacion Comments No. of persons using each unit Sewar System [ ] a0 Other dispesal syscan(s) { ] yes, if yes, type of trearmenc