Natural Gas Public Awareness Survey Name First Last Date(Required) MM slash DD slash YYYY Organization Do you have natural gas pipelines running through your community?(Required) Yes No Do you know the name of your local natural gas company?(Required) Yes No If yes, who?(Required) Have you heard or seen a message regarding natural gas safety in the last 12 months?(Required) Yes No If so, about how many?(Required)Please enter a number less than or equal to 999999.Before today, about when was your last contact with someone from the natural gas industry related to pipeline safety?(Required) (If known, fill in approximate date or number of weeks, months, or years ago.) Or N/A for no contact. Do you have the number to call the natural gas company if there is an incident or you need more information?(Required) Yes No Do you know who regulates the natural gas company in this community?(Required) Yes No Do you know what precautions an excavator should take prior to digging to avoid accidentally hitting a natural gas pipeline?(Required) Yes No If yes, what are they?(Required)Are you familiar with the one-call line?(Required) Yes No How would you rate the adequacy of information you have about natural gas safety (e.g., how to recognize a leak, what to do when there is a leak, what first responders should do, etc.)?(Required) About right Too much Not enough Does your community have an emergency response plan to deal with a natural gas leak (regardless of whether intentional or accidental.)?(Required) Yes No Are you aware of any pipeline leaks that occurred in your community in the last 2 years?(Required) Yes No If yes, how many?(Required) What were they?(Required) Have any of your local citizens or businesses expressed concern in the last 12 months about any issue regarding natural gas safety?(Required) Yes No If yes, what was it?(Required) Overall, do you feel the natural gas industry has an adequate public safety awareness program?(Required) Definitely yes. Pretty much so. Not sure. Don't know. Probably not. Definitely not.
