DEPARTMENT OF HOMELAND SECUFHTY FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. Control No. 1660-0057 ANhJlNSTON SITE SURVEY Expires April 30,2008 CSEPP Public Affalrs IPT Questlonnalre PAPERWORK BURDEN DlSCLOHlW NOTICE Publi reporting burden for thls form is estimated to average 25 hours per response. The Then estimate Includes the time for reviewing instwctlons. searchimg existing data suurces, girtherlng and malntalnlng the data needed, and completing and subrnlttlng thb form. You are not regulred to respond to this cdlertlon of !&mation unless tt dlspbys a valW OM6 cMtrol numbcr. knd comments rcgudlng the accuracy of the burden esttlmate and any suggestions for tedwlng the burden to: lnformatlon Collections Management Department of Homeland Security, Federal Emergency Management Agency, 500C Street SW. Washington. DC 20472 and Papemark Reduction Pmject (16MM057). Not= DOnot und your cornplotad fwmto thlr mddrru. ALL CAPS: htructions for the people that wilt be making the survey calls and for the survey administrator. General Introduction... Hello, this is (FIRST AND LAST NAME) of CR Dynamics, working with the Federal Emergency Management Agency on behalf of your local emergency preparedness providers. We are not selling anything. We are cotlducting a survey among people living near the Anniston Army Depot. This survey has been approved by the Ofice of Management and Budget (OMB) and has an estimated response time af 10 to 15 minutes. Your participation 1s strictly voluntary. Do ysu have a few minutes to answer a few questions? IF YES: Are you 18 years of age or older? IF NO: Is there someone else I can talk to who is 18 years of age or older? TF L'NAVATLABLE SCHEDULE CALLBACK AND TERMINATE. PLEASE COLLECT THE hIEROF CALL5 TERMINATED AS "LANGUAGE BARRJER" AND PROVIDE THIS NUMBER TO THE ALABAMA PIOS SKLP S1 AND S2 FOR CLEBURNE COUNTY TELEPHONE NUMBERS. SI. Do you live in (NAME OF COUNTY PROVIDED BY FPS CODE) County? 1. Yes (SKIP S2) 2. No S2. IF NO: What county do you live in? 1. Calhoun 2. Clay 3. Clebume 4. Etowah 5. St. Clair 6. TaIladega 7. None of the above counties TERMINATE CALL 1. Are you aware of the chemical agents that are being destroyed at the Anniston Army Depot? 1. Yes 2. No 3. (ENTER VERBATIM COMMENTS TO THIS QUESTION IN ADDITION TO RESPONDENT'S YES/NO RESPONSE) 2. How would you know if there were a chemical emergency at the Anniston hyDepot? (DON'T READ, CATEGORIZE RESPONSE AS FOLLOWS, ACCEPT MULTIPLE RESPONSES) 1. AM/FM radio 2. FamilyIFriend 3. SiredLoudspeaker 4. Tone alert radio (TAR) 5. Television 6. Weather radio ----- 97. Other (PLEASE SPECIFY) 99. Don't know 3. What actions would you take if you found out there was a chemical emergency at the Anniston Army Depot? (DON'T READ, CATEGORIZE RESPONSE AS FOLLOWS, ACCEPT MULTIPLE RESPONSES) WAIT AND ASK: Are there any other actions you would take? Await instructions to shelter in place, evacuate, or stand-by. Contact familylfriends Evacuate Go to work (depot, hospital, fire dept, police) Shelter in place Turn odlisten to AM/FM radio Turn odWatch television Other (PLEASE SPECIFY) Nothing Don't know 4. If you were instructed to shelter in place, what actions would you take? (DON'T READ, CATEGORIZE RESPONSES AS FOLLOWS, ACCEPT MULTIPLE RESPONSES) WAIT AND ASK: Are there any other actions you would take to shelter in place? Close doors and windows Close heatingair conditioning vents Contact familylfriends Emergency planlFamily emergency plan Evacuate FindJGather family Follow instructions1Do what told Get foodlwater supply Go insidelstay inside Go into shelter room of your home/workplace Get supplies (clothes/cell phonelbooWcandleslgames/medicinelflashlight,ect) Go to work (depot, hospital, fire dept, police) HystericayPanic/Die KneeVPray Listen to radio1TV for hrther instructions Locate/collect pets Lock doors and windows Seal doors and windows of shelter room Take radio1TV into shelter room Turn off heatindair conditioning systems Use emergency kit Use shelter-in-place kit .---- Other (PLEASE SPECIFY) Nothing Don't know How would you know it would be safe to stop sheltering-in-place? (DON'T READ, CATEGORIZE RESPONSES AS FOLLOWS, ACCEPT MULTIPLE RESPONSES) AM/FM radio Chemical Stockpile Emergency Preparedness Program (CSEPP) Office FamilyRelative Fire department FriendfNeighbor Local emergency management agency (EMA) Police Sheriffs department Siren Tone alert radio (TAR) Television Weather radio 13. Work 97. Other (PLEASE SPECIFY) 99. Don't know 6. If you were instructed to evacuate, what actions would you take? (DON'T READ, CATEGORIZE RESPONSES AS FOLLOWS, ACCEPT MULTIPLE RESPONSES) WAIT AND ASK: Are there any other actions you would take to evacuate? 1. Await instructions1Listen for help 2. Contact family members before leaving 3. Check wind direction 4. Do not have transportation 5. Evacuate in a specific direction 6. Evacuate to a specific destination 7. Evacuate using specific route 8. Follow instructions/Do what told 9. Gather family 10. GetICheck calendar 1 1. GetICheck preparedness kitlpacketlpamphlet 12. Getkids(notfromschoo1) 13. Get kids from schoolIGo to school for kids 14. Get personal items (pack clothes, food, water, gas) 15. Go to work (depot, hospital, fire dept, police) 16. Leave home or workplace1Get out of town/Get in car and go 17. Listen to TVIradioltone alert radio for correct evacuation route 18. Listen to TVIradioltone alert radio for location of reception/assistance center 19. Listen to TVIradioltone alert radio (general) 20. Locate/collect pets 21. Need evacuation assistance 22. Tell neighbors and others to evacuate 23. Turn off heatingiair conditioning systems 24. Turn on TVIradioltone alert radio (general) 25. Wait for family members before leaving 26. Would not evacuate ----------- 97. Other (PLEASE SPECIFY) 98. Nothing 99. Don't know 7. In the event of an evacuation, do you have a pre-planned direction, route or destination? (DON'T READ, ACCEPT MULTIPLE RESPONSES) 1. Yes, direction 2. Yes, route 3. Yes, destination 4. No, none 5. Depends on the wind direction 97. Other (PLEASE SPECIFY) 8. If a chemical accident occurred at the Anniston Army Depot, where would you get instructions on how to protect yourself and your family when you hear the warning signals? (DON'T READ, CATEGORIZE RESPONSE AS FOLLOWS, ACCEPT MULTIPLE RESPONSES) 1. 911 2. AM/FM radio 3. Anniston Army Depot 4. Anniston Chemical Demilitarization Community Outreach Office/Outreach Office 5. Calendar 6. FamilyIFriends 7. School 8. Information received through the mail 9. Local emergency management agency (EMA) 10. Newspaper 11. Preparedness kit/package 12. Pamphlet/Brochure 13. Police, local or state 14. Siren/Loudspeaker 15. Television 16. Tone alert radio (TAR) 17. Weather radio ----------- 97. Other (PLEASE SPECIFY) 98. None 99. Don't know 9. Do you or your family have an emergency plan? 1. Yes 2. No 10. Has your local emergency management agency given you the information and materials you would need to make a family emergency plan? 1. Yes 2. No 1 1. Please answer yes or no to the following questions: A. Are you familiar with the names of the major roads and highways in your area? ASK QUESTION 11B IN CALHOUN AND CLAY COUNTIES ONLY B. Do you know the evacuation route you should follow in the event of an evacuation? ASK QUESTIONS 11C AND 11D IN TALLADEGA COUNTY ONLY C. In the event of an evacuation, do you know the city that has been designated as the final destination for people leaving your area? (IF NO: SKIP D) D. Do you know the quickest route to that city? ALL RESIDENTS E. In the event of an emergency, do you have a family meeting place? F. Do you have an out-of-area telephone contact? G. Do you have a disaster preparedness kit (emergency supplies such as food, water, medications, first aid supplies, flashlight, and battery-operated radio)? H. Do you have a shelter-in-place kit with tape, plastic, and instructions? ASK QUESTION 111 IN CLEBURNE COUNTY IF YES IN 11H I. Did Clebume County Emergency Management Agency (EMA) provide you with a shelter-in-place kit? ALL RESIDENTS J. Have you identified a room in your home that you would use for sheltering-in-place? (IF NO: SKIP K) K. Do you have an AMEM radio or TV in this room? ASK QUESTIONS 12-13 IN CLEBURNE COUNTY ONLY 12. What is your level of confidence in the following.. A. The Anniston Army Depot Personnel? B. The Clebume County Commission? C. The Clebume County School System Personnel? D. The Clebume County Sheriffs Department? E. Your County's Fire Department? F. The Clebume County Emergency Medical/Ambulatory Service? G. The Clebume County Emergency Management Agency (EMA)? IF THE RESPONDENT SAYS "DON'T KNOW SAY: "Please choose the one that most closely reflects your opinion." (READ 1-4) 1. Very confident 2. Somewhat confident 3. Not very confident 4. Not confident at all ASK QUESTION 13 IN CLEBURNE ZONE A-12 ONLY 13. What is your level of confidence in the following... A. Your City's Elected Officials (Mayor and City Council Members) B. Your City Police Department C. Your City Fire Department D. Your City Parks and Recreation Department "Please choose the one that most closely reflects your opinion." (READ 1-4) 1. Very confident 2. Somewhat confident 3. Not very confident 4. Not confident at all ALL RESIDENTS 14. How confident are you that you know how to shelter in place in the event of a chemical emergency? "Please choose the one that most closely reflects your opinion." (READ 1-4) 1. Very confident 2. Somewhat confident 3. Not very confident 4. Not confident at all 15. Do you have children in a local school in grades K-12? 1. Yes GO TO 16 2. No GO TO 22 3. NAIrefused GO TO 22 RESPONDENTS WITH CHILDREN ANSWER QUESTIONS 16 16.