Did You Feel It? — nmhwb0615a

Tuesday, June 15, 2004 at 08:34:21 UTC

OMB No. 1028-0048
Expires 03/31/2012SOUTHEASTERN MISSOURI

Your location when the earthquake occurred

Country Select your country.
Zip CodeInput your 5-digit U.S. zip code.
Address(Optional) Street address. Used for geocoding to improve our analysis.
RegionSelect your region.
CitySelect your city.

Section 1 of 6

Your situation when the earthquake occurred

Did you feel it Yes No If you were sleeping, did it wake you.
Physical Situation Select the option that best describes your physical situation during the earthquake.
Other If 'Other' please describe.

Building/structure type Select the option that best describes the structure you were in at the time of the earthquake.
Other If 'Other' please describe.
Were you asleep
Did others feel it Your best guess at what others nearby may have felt.

Section 2 of 6

Your experience of the earthquake

Shaking Strength How would you best describe the shaking?
Shaking Duration About how many seconds did the shaking last?
Your Reaction How whould you best describe your reaction?
Your Response How did you respond during the shaking?
Other If 'Other' please describe.
Stand or Walk Was it difficult to stand and/or walk?

Section 3 of 6

Earthquake Effects

Free-hanging objects Did you notice any swinging/swaying of doors or other free-hanging objects?
Sounds Did you hear creaking or other noises?
Shelved Objects Did objects rattle, topple over, or fall of shelves?
Hanging Pictures Did pictures on walls move or get knocked askew?
Furniture Did any furniture or appliances slide, topple over, or otherwise become displaced?
Large Appliances Was a heavy appliance (refrigerator or range) affected?
Walls/Fences Were free-standing walls or fences damaged?

Section 4 of 6

Contact Information (Optional)

Name
Email Your email address.
Phone Your phone number.
Additional Comments You may use this box to clarify answers or to make observations that are not accommodated by other questions. You may also give first-person descriptions of how the earthquake affected you. USGS scientists may use some of the information that you enter in qualitative descriptions of shaking or damage in USGS publications. You would be identified as “an observer” and your location would be given in general terms. Parts of some first-person accounts may be reproduced as quotations in USGS publications.

Section 6 of 6