What Was your Situation During the Earth Quake?

Inside

Others

In Moving Vehicle

In Stopped Vehicle

Outside

If you Were inside please select the type of building or Structure

Apartment building

Single family Home or duplex

Other, Please describe:

Trailer/RV With no Foundation

Mobile home /Permanent Foundation

Office building /School

Are you Asleep during the earthquake?

No

Woke me up

Slept through it

Did you feel the earthquake?(if you were asleep, did the earthquake wake you up)

No answer/Don’t know/nobodyelse nearby

Yes

No

Did other nearby feel the earthquake?

Most other felt it, but some did not

Some felt it, but most did not

No others felt it

No answer/Dont't know/Nobody else nearby

(Almost) everyone felt it

How would you best descripe the ground shaking?

Not felt

Violent

Strong

Moderate

Mild

Weak

About how many seconds did the shaking last? (check one)

How would you best describe your rection?

No reaction/Not felt

Very frightend

Exteremely frightened

Somewhat frightened

Excitement

Very Little Reaction

How did your respond?

Other

Ran outside

Ducked and covered

Moved to doorway

Took no action

Was it difficult to stand or walk?

Yes

No

Did you notice the swinging/swaying of doors or hanging objects?

Yes, Violent Swinging

Yes, Slightly swinging

No

Did you notice creaking or other noises?

No

Yes, loud noise

Yes, slight noise

Did objects topple over or fall off shelves?

Rattled loudly

Rattled Slightly

No

Nearly everthing fell off

Many fell off

A few Toppled or fell off

Did pictures on walls move or get knocked askew?

Yes, but did not fall

No

Yes, and some fell

Did any furniture or appliance slide, tip over, or become diplaced?

Yes

No

Was a heavy appliance (refrigerator or range) affected ?

Yes, shifted by inches

Yes, some contents fell out

No

Overturned

Yes, shifted by a foot or more

Were free standing walls or fences damaged?

Yes, some Partially fell

Yes, Some were cracked

Building moved over foundation

No

Yes, Some fell completely

If you were inside, was there any damage to the building?

Many large cracks in walls

Old chimney, Major damage or fell down

A few large cracks in walls

Masonry fell from from block or brick walls

one or several cracked windows

Many windows cracked or broken out

Separation of porch, balcony, or other additi

Hair cracks in walls

Cracks in Chimney

Outside wall(s) titled over or collapsed

No damage

Ceiling tiles or lighting fixtures fell

Modern chimney, Major damage or fell down

Additional Comments

Contact Information (optional)

Languages

National Center for Seismology

Did you feel an Earthquake?

Use a map to input and/or verify your location

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