Appendix 3n - Filled Quetionner in Surabaya
(See photo in Appendix 3c)

Quetionner

STUDY OF GLOBAL ENVIRONMENT IMPACT STUDY OF URBAN DEVELOPMENT AND HOUSING CONSTRUCTION IN INDONESIA

URBAN BUILDING TYPOLOGI

Number of Set		: 2

Name of Location		: Kecamatan Gubeng

City				: Surabaya

RESPONDENT IDENTITY

Respondent name		: Dra. Sri Mulyani Murdiyati Suharyo Kunto

Sex				: Female

Respondent address	: Jl. Ngagel Jaya Utara III No. 16 Surabaya Timur

Occupation			: House Wife

Date of Survey		: May 14, 2000

Surveyor name		: Ade Erma Setyowati

PUSAT PENELITIAN DAN PENGEMBANGAN TEKNOLOGI PERMUKIMAN
BADAN PENELITIAN DAN PENGEMBANGAN PERMUKIMAN DAN PENGEMBANGAN WILAYAH
DEPARTEMEN PERMUKIMAN DAN PENGEMBANGAN WILAYAH
Jl. Panyaungan Cileunyi Wetan Kab. Bandung 40393 PO Box: 812 Bandung 40008 - Indonesia
Phone: 62-22-7798393 (4 lines)   Fax. 62-22-7798392   Email: svr1litp@pu.go.id

I. General Data

1. Municipal	: Kotamadya Surabaya
a.	Area			: 32.636,68 Ha
b.	Population density		: 76
c.	Number of Population	: 2.473.272

2. District	: Kecamatan Gubeng, Surabaya Timur
a.	Area			: 79.990 Ha
b.	Population density		: 196
c.	Number of Population	: 156.428

3. Sub District	: Pucang Sewu
a.	Area			: 94,5 Ha
b.	Population density		: 65
c.	Number of Population	: 14.558

II. Area/Region Data 
2.1.General

1. Housing Developer :
           Developer	•	 Community	
2. Land lot	: ------------------------------
3. Density	: ------------------------------
4. Population	: ------------------------------
5. Building Typology around this area.

    Detached house	   Shop house	   Shop / small shop	
•	Row houses	   Office house	   Office	
•	Flat house	   Public building	   Policlinic	
   Platform House 	•	Traditional Market	   School	
    Mosque	   Sport Area		

2.2. Household
1. Type of House :

    Detached house	•	Shop house	•	Flat House	
•	Row houses	•	Office house	•	Platform House	

2. Main Activities				: House

3. The Number of Dwellers   : 2 person

Age
(Year)	Occupation 	Estimation of Staying at  Home
(Hours / Day)	
1. 65	1. Retired	1. 24 hours	
2. 30	2. Medical doctor	2. 10 hours	
        
 4. Building Shape:
    Rectangular	•	 U shape	•	 L shape	•	 Irregular	•	 Others ----------------	

5. Year of Construction		: 1962
6. Lot Area			: 350.25 M2
  7. Building Area 			: 200 M2
a.	Number of bedrooms	: 7  
b.	Area of each bedroom	: 5 M2,	30 M2,	7.5M2.
c.	Area of Bathroom		: 1.25 M2, 
d.	Area of Kitchen		: 10 M2.
8. Open Space 			: 75 M2
9. Plantation:

No.	Kerimbunan Tanaman
% volume	Density of plantation
% area	Name of plantation (local)	Type of leaves surfaces	Types of bush	Area	
			Salami				
			Sambang Dara				
			Pandan Suji				
			Ketepeng				
			Puring				
			Asem				
			Srikaya				
			Lidah buaya				
			Sirih				
			Jeruk Purut				
			Murbei				
			Katu				
			Pecut kuda				
			Encok				
			Lempuyang				
			Kunir				
			Pandan				
			Cocor bebek				
			Kembang sepatu				
			Jinten				
			Delima wulung				
			Lempuyang wulung				
			Kunir				
			Jahe				
			Laos				
			Belimbing lingir				
			Ceremai				
			Mangga				
			Cabe besar				
			Cabe rawit				

10. Major Building Materials

a.	Walls :
     Bricks	•	 Lime	•	Crushed stone	•	 Others	
•	 Wood	•	 Cement		•	 Concrete		

b.	Roof :
   Tiles		•	Shingle roof		•	Zinc	

c.	Roof  construction :
•	 Steel	     Wood	

d.	Floor
•	 Stone			•	 Parquet	•	Marble	
         Terrazzo	•	 Ceramic		

e.	Window frame	:
•	. Aluminum
	     Wood	

f.	Door frame
•	Aluminum
	     Wood	

g.	Door panels
•	Glass
	   Wood 	

11. Building construction :
•	 Reinforced concrete	    Composite	•	Steel construction	•	Wood	

12. Photo	: See appendix 3a

III. Energy Usage 

1. Used source of energy:
a.	 Cooking	 :
   Gas : 2/3 tubes per
•	 Day		•	 Week	        Month	

•	Kerosene	: ------------ liter per
•	 Day		•	 Week	•	 Month	
   Electricity	: ---------------------
•	 Others 	: -----------------

b.	 Lighting
   Electricity	•	Kerosene lamp	•	Others : -----	

c.	Ventilating			:
•	Electricity	     AC	   Fan	•	Other : ----	

d.	Water heating
•	Electricity	•	 Gas	•	Solar	

e.	Ironing
   Electricity	•	Wood bracket	

f.	Cloths washing:
   Electricity	   Others	

g.	 Other usage
   Entertainment (Radio / TV)	•	Others	

h.	Garbage handling
   Collected by cleaning services	•	 Others : ---------	
•	Burned		

2. Vehicles to travel or business
     Outside neighborhood
•	Inside neighborhood

No.	Type	Year	Number 	Traveling distance (Km)	Fuels need	
					Solar	Gasoline	
1.	Cars	1987	1	30 Km/day		10 Liters/day	
2.	Motor cycles	1975	1	-	-	-	
3.	Public transportation			Bemo, taxi			
4.	Other						

3. Total energy usage per month:
    Electricity		Rp. 100.000	    Gasoline 300 liters	
    Gas	                  2/3  tube	•	 Solar  	-------------- liter	
•	 Kerosene	             - ------------- liter	•	Others		--------------	

Surveying main building materials

a.	Walls:
                   Bricks	28231 buah	•	Lime------------ M3	
•	Wood	------------ M2	                Cement 212.37 Sack	
                   Bar 193.98 KGs	                Sand (1) 3.46 M3	
                   Sand (2) 50.16 M3	                Sand (3) 4.31 M3	
•	Stone	------------ M2	•	Others: --------- M2	
                    Ties        1.85 Kg	                Colored cement 3.15 Kg	
                  Crushed Stone 24.02 M3	      Crush stone 2/3  3.46 M3	

b.	Roof :
                   Roof tiles 220  M2			•	Shingle roof---------M2	
•	Zinc  ------------- M2			•	Eternit (4 mm) 220 M2		
c.	Roof construction :
•	Steel        ------- KGs				                              Wood(see note 1)  M3	
d.	Floor
•	 Stone	------- M3			•	 Parquet -------------- M2	
•	Terrazzo---- M2	                               Ceramic 244.87M2	
•	 Marble ----- M2	•		
e.	Window frame	:
•	Aluminum: --------- 	                               Wood (see note 1) M3	
f.	Door frame
•	Aluminum :--------Baja	                              Wood (see note 1) M3	
g.	Door panels
•	Glass :--------------- M2		                                Wood (see note 1) M3	

Note: 
1.	Total usage of Wood (roof construction, door frame, window frame and door panel= 91.81M2
2.	Total usage of glass (window panel) = 33 M2
3.	Teakwood sized 120/240 = 28.56 sheet