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Pipeline Safety Survey

  1. Madison Natural Gas Pipeline Safety Survey

  2. 1. In the last year, have you seen or heard any information from the City of Madison relating to pipeline safety?*

  3. 1.a. What was the source of the information?*

    Check all that apply

  4. 2. Have your or has anyone in your household ever tried to obtain information about pipeline safety in the last 12 months?*

  5. 2.a. Where did you try?*

    Check all that apply

  6. 3. Do you live close to a petroleum or gas pipeline?*

  7. 4. What would you do in the event you were first to see damage to a pipeline?*

    Check all that apply

  8. 5. What would you do if you saw someone intentionally trying to damage a pipeline?*

    Check all that apply

  9. 6. Have you ever called a pipeline operator, 911, or anyone else to report a suspicious or worrisome activity near a pipeline?*

  10. 6.a. What did you report?*

    Click all that apply

  11. 7. Have you or anyone in your household or company ever encountered a damaged pipeline or product released from a pipeline?*

  12. 8. Have you ever passed information about pipeline safety to someone else?*

  13. 9. Who would you contact if you needed to know the location of a gas line or other utility on your property?*

  14. 10. Do you agree or disagree that the City of Madison has been doing a good job of informing people about pipeline safety?*

  15. Leave This Blank:

  16. This field is not part of the form submission.