Reminder: Please, everyone, complete and send their surveys by Saturday.

Gracias.

Brandt Parker

Emergency Disaster Preparedness- Gold Hill community survey

A group has organized in Gold Hill to develop a plan for future emergencies. This questionnaire is to determine what resources and needs exist in town. Please help us and fill out the form. You can email it back to Brandt Parker: bparker258@nullgmail.com  or print and send by pony express to me at: 258 Sawmill Road, Jamestown, CO 80455. Please do either by Saturday 4/18/15.  Don’t mind the humor, were hoping to engage you!

If the grid to were do go down for 3 days to 3 months, how prepared is your household for wildfire, flood, winter storm, disease or epidemics, nuclear radiation, acts of terror, drought, earthquake, landslide, tornado, running out of alcohol or your ‘favorite fruit or herb’?

Just put an ‘X’ before an item if it applies and /or go prosaic on the lines provided.

1)            Water/rain collection/surface water/ cisterns/filtration

1. a) after 1 day could be inconvenient
2. b) after 2 days could be a problem
3. c) have an old hand pump for drinking water when we used to go camping
4. d) got a luxury bunker out back with supplies for 3 months

what do you want to know?________________________________________________________

what resources can you share?­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­_____________________________________________________

2)            Food

1. a) I’m trying to lose weight
2. b) after 2 days could be a problem
3. c) have some canned food
4. d) Got Milk?

what do you want to know?________________________________________________________

what resources can you share?­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­_____________________________________________________

3)            Elimination!

1. a) I’ll hold it
2. b) after 2 days could be incontinent
3. c) after 2 days could be a problem or might explode
4. d) water availability will limit my flushes

what do you want to know?_______________________________________________________

what resources can you share?­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­_____________________________________________________

4)            Energy and Communication

1. a) Don’t talk to me, I got dis under control
2. b) I am completely dependent on the grid for communication and have no backup power source
3. c) I have alternative power sources (solar (electric or hot water), wind (electric or water pumping), wood/coal heat, electric generator, etc.
4. d) I have a water supply if grid power is off and can access when power is off.
5. e) In the event of a prolonged power outage, what would impact you the most?

what do you want to know?_______________________________________________________

what resources can you share?­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­_____________________________________________________

5)            Generators and Town needs

1. a) after 2 days could be a problem
2. b) we have a small generator
3. c) I have a large rodent on a wheel
4. d) got a luxury bunker out back with supplies for 3 months

what do you want to know?_______________________________________________________

what resources can you share?­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­_____________________________________________________

6)            Health/Medications/ Herbs /Dental Personal needs

1. a) after 2 days could be a problem
2. b) with roads and mail down how will I get my meds?
3. c) my prescriptions are on file at my pharmacy, how can emergency workers get medications to me, especially the more controlled schedule 1-4 drugs
4. d) Jesse Pinkman is my bitch, YO!

what do you want to know?________________________________________________________

what resources can you share?­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­_____________________________________________________

7)            Shared Resources

1. a) When another disaster or other event occurs, do you have tools, skills or knowledge you would be willing to share to help others in the community?
2. b) Do you have tools you would be interested in contributing to a Gold Hill tool library?
3. c) Are there specific tools you would like to have in a shared tool library rather than purchase your own?
4. d) got a party in my pocket
5. e) got a luxury bunker out back with supplies for 3 months

what do you want to know?_______________________________________________________

what resources can you share?­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­_____________________________________________________

8)            Education Materials and Preparedness

1. a) I read Walden
2. b) I was a Boy/Girl Scout
3. c) I have seen the movie ‘Smoke Signals’
4. d) I have read ‘Station Eleven’- super Ebola- like outbreak, only bands of people left.

what do you want to know?_______________________________________________________

what resources can you share?­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­_____________________________________________________

9)            The uses for a new Town Hall- seriously, there is big grant money out there

1. a) after 2 days could be a problem
2. b) Will they offer Bingo?
3. c) Do we put the ‘Mayors’ picture on the wall? Darts?
4. d) got a luxury bunker out back with supplies for 3 months

what do you want to know?________________________________________________________

what resources can you share?­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­_____________________________________________________

Optional:

Your name and email:_________________________________________________________

Address: ___________________________________________________________________

Thank you!