Monday, November 29, 2010

4th Ward Preparedness Survey

Here is the 4th Ward Preparedness Survey - just in case you didn't get a chance to fill it out on Sunday!

Just print it out and give it to me when you're done! Or download a copy of the Survey here.

Springfield 4th Ward


1. Are you debt-free?                                Y            N
(If "yes", skip to section "Food Storage".)
2. Please complete questions indicating what type of debt you have:
a) home mortgage                    Y            N
b) car                                        Y            N
c) credit card                            Y            N
d) recreational vehicle(s)          Y            N
e) other                                     Y            N
3. Are you actively following a plan to become debt-free?                Y            N
4. Estimate how many years/months before you become debt-free: __________

Food Storage

5. Do you have a functioning home food storage program?                    Y            N
6. Approximately how many gallons of water do you have stored (not including water heater, toilet tanks)? _____________
7. Approximately how many pounds of grain and/or legumes do you have stored (rice, wheat, etc)? __________
8. Are you using your storage items on at least a weekly basis?            Y            N
9. Are you currently storing rotating food supplies?                              Y            N
(canned foods, boxed foods, condiments, etc)
10. Estimate how many months your family could survive on your overall food storage: _____________

Fuel Storage & Use

Please answer the following as if electricity/natural gas service is disrupted:
11. Do you have an alternative heating source?                                                Y            N
(wood burning stove, propane, etc.)
12. Estimate how many days of fuel for such heating you have stored: ________
13. Estimate how many hours lighting you have stored (candles, lanterns, generator, etc.): _________
14. Do you own an alternate cooking device?                                                 Y            N
15. Do you own a dutch oven/outdoor cookware?                                         Y            N

Medical Supplies

16. Do you have a family first aid kit?                                                     Y            N
Personal Hygiene
            17. Do you have detergent/liquid laundry soap stored?                    Y            N
18. Do you have liquid/bar hand soap stored?                                  Y            N
            19. Do you have toilet paper stored?                                                  Y            N
20. Do you have paper/cloth towels stored?                                     Y            N

Alternative Dwelling

21. Do you have an alternative dwelling?                                             Y            N
(tent, camper, trailer, etc.)
22. Do you have a 72-hour kit for each family member?                    Y            N

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