Emergency Personnel - Pipeline Awareness Survey
Survey ID *
Your answer
Name and Title
Your answer
Department / Organization *
Your answer
Location *
Your answer
SURVEY - Pipeline Safety
In the last 12 months have you seen or heard any information regarding gas pipeline safety as it applies to your organization?
Have you ever heard of 811? *
Do you know how to recognize a pipeline leak? *
Do you know how to recognize a pipeline right-of-way? *
How would you know if there is a pipeline near you? (check all that apply) *
Required
What would you likely do if you saw suspicious or construction related activity on or near a pipeline right-of-way? *
What would you do in the event of a pipeline emergency? (check all that apply) *
Required
If you were planning on digging, which of the following actions would you take? (check all that apply) *
Required
How often do you check to see if a pipeline exists, and where it is located, prior to digging? *
Which was the most recent pipeline incident in your community that required a response by law enforcement and/or emergency responders? *
What was the cause of the incident? *
Underground pipelines can be marked by: *
To assist in identifying a pipeline leak you should use the following senses: *
High-pressure pipelines are buried: *
If there is no odor from a leaking high-pressure pipeline, you may assume it is safe to approach the leak for closer inspection? *
Do you want more information from Fountaintown Gas Co., Inc. about natural gas and/or pipeline safety?
Contact Information
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms