Did You Feel It? Report It!

You can help by completing the following questionnaire. Even if you did not feel the quake, but were in the general area of the epicenter, please answer the questionnaire (We want to know the areas where the quake was felt and also where the quake was not felt). Your answers will be used to map the distribution of seismic intensity.

LOCAL DATE & TIME are required for when the quake was felt. Your city and zip code are also required. All other data (name, email, phone number) are optional, but the zip code is required to determine the seismic intensity in your area. The other data will be useful to restrict further the different intensities in the places where the quake was felt.

Date of the earthquake

Mes: Day: Year:

Time of earthquake

Hour: Minute:

Reporter Information

Name

Telephone

* Town/City

*Zip Code

Your answer to the following questions is optional. However, your response to the maximum number of questions would help us to estimate more precisely the intensity of the earthquake. Where you were during the earthquake? Did you feel the earthquake?

Yes

Were you asleep? Did others around you feel it?

Your experience during the quake:

How would you best describe the shaking? How many seconds did the shaking last (approximate)

How would you best describe your reaction How did you respond Was it difficult to stand and/or walk

Yes

Earthquake Effects:

Did you notice any swinging/swaying of doors or other free-hanging objects? Did you hear creaking or other noises? Did objects rattle, topple over or fall of shelves? Did pictures on walls move or get knocked askew? Did any furniture or appliances slide, topple over, or otherwise become displaced

Yes

Were free-standing walls or fences damaged?

Additional Comments:

If you know the type of terrain on which the structure was built, please indicate here:

Make sure you fill the form for proper earthquake!