Emergency Personnel - Pipeline Awareness Survey
Survey ID *
Name and Title
Department / Organization *
Location *
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?
Clear selection
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) *
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) *
If you were planning on digging, which of the following actions would you take? (check all that apply) *
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?
Clear selection
Contact Information
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy