Hafod-Yr-Ynys Air Quality Feasibility Study (WelTAG Stage 3)

It should take you approximately 10 minutes to answer all the questions. If you need to speak to someone about this survey then please email:ehadmin@.gov.uk or telephone 01443 811346/811347.

Privacy notice (data protection)

Your response to this questionnaire is being collected by Caerphilly County Borough Council (as data controller) and will be used to inform the feasibility study and provide evidence to help us make decisions about how to improve air quality in Caerphilly CBC. By submitting your response, you are giving your consent for us to use the information you have provided. When results are shared publicly or with other organisations, your information will be anonymised so you cannot be identified. If you provide contact details then we may send you messages in line with the preferences you give, but you can opt‐out at any time.

We will keep your information safe and secure in line with UK data protection law. Your data will be processed by the relevant services (departments) within Caerphilly County Borough Council.

Q1 Please indicate your interest in this consultation (please select all that apply):

A resident living in 1-20 Woodside Terrace,1-2 Woodside shops or Yr Adfa A resident of CCBC not living in 1-20 Woodside Terrace,1-2 Woodside shops or Yr Adfa A resident of a neighbouring Local Authority An elected member Representing a local group or organisation As someone who works in Caerphilly county borough As a local business person Other

If you have indicated other, please give details:

Q2 Please could you provide your postcode in the space below e.g. CF82 7PG

Q3 Do you agree with the outcome of the Hafod-Yr-Ynys Air Quality Feasibility Study WelTAG Stage 3 Report?

Yes No Q4 Please could you provide a brief explanation to your answer contained in Q3 in the box below:

Q5 Do you agree with the proposal that 'Do minimum' is the preferred option?

Yes No

Q6 Please could you provide a brief explanation to your answer contained in Q5 in the box below:

Q7 Please indicate your gender below:

Male Female Prefer not to say Other

If you selected other, please specify in the box below your gender Q8 I am aged:

11-15 years 16-25 years 26-35 years 36-50 years 50-64 years 65 years and over Prefer not to say

Q9 If you feel that your response to this survey has been influenced (positively or negatively) because of any of the following: your ethnic origin, gender, age, marital status, sexual orientation, disability, gender reassignment, religious beliefs or non‐belief, use of Welsh language, BSL or other languages, nationality or responsibility for any dependents, please give details in the box provided:

Q10 I confirm that I wish to submit the information entered into this form to Caerphilly County Borough Council. I understand that this information will be collated via Snap Surveys, a third party organisation https://www.snapsurveys.com/survey-software/privacy-policy-uk/ and for it to be used as described in Caerphilly County Borough Council's privacy notice https://www.caerphilly.gov.uk/CaerphillyDocs/FOI/PrivacyNotices/Privacy-Notice- Consultations-Surveys.aspx

I confirm the above

Thank you for taking the time to respond to this survey. Please return this form to any of the main Council offices or your nearest library,leisure centre, cash office, housing office or customer first centre. If youp refer, you can also return the survey in the post to Consultation and Public Engagement Officer, Policy Unit, Caerphilly County Borough Council, Penallta House, Tredomen Park, , ,CF82 7PG.