Prescribed Fire Survey 2007

Did you receive a survey postcard in the mail?

Yes

No

If yes, please enter the postcard code

Did the prescribed burns affect you in any way in 2007?

Yes

No

If yes, how?

Did you see or smell smoke during the burns?

Yes

No

If yes, was it enough to cause you discomfort?

Yes

No

If the smoke did cause you discomfort, how?

If there was smoke, did it impair visibility along roadways?

Yes

No

If there was smoke on the roadways, please explain how visibility was impaired.

Do you feel you received adequate notification?

Yes

No

If no, how can we be more effective?

Any other comments?

First Name

Last Name

Street Address

Address Line 2

City

State

Zip Code

Phone Number

Email Address

Indicates Response Required