About You

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1. What zip code do you work / live in?

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2. Which of these options best describes you?

Poll question: 2. Which of these options best describes you?. Select one option.
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3. How long have you lived or worked in the area?

Poll question: 3. How long have you lived or worked in the area?. Select one option.
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Flooding from Rainfall and Storms

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4. Indicate where you have seen flooding due to extreme rainfall or storms. Click Add Point or Draw Line in the top right corner of the map to draw on the map, or write the street intersections below where you have seen flooding due to extreme rainfall or storms.

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Write the street intersections where you have seen flooding due to extreme rainfall or storms.

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4.1 How often does flooding occur at this location?

Poll question: 4.1 How often does flooding occur at this location?. Select one option.
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4.2 What have you experienced during these events?

Poll question: 4.2 What have you experienced during these events?. Select one or more options.
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4.3 How long did it take for water to clear?

Poll question: 4.3 How long did it take for water to clear? . Select one option.
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Sewer Backups and Drainage System

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5. Mark on the map or write the street intersections below where you have seen sewer back flows of water pooling.

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Write the street intersections where you have seen sewer back flows of water pooling.

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5.1 What have you experienced during these events? (lack of access, infrastructure issues, odor, etc)

Poll question: 5.1 What have you experienced during these events? (lack of access, infrastructure issues, odor, etc). Select one or more options.
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5.2 How long did it take for water to clear?

Poll question: 5.2 How long did it take for water to clear? . Select one option.
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Impacts on Daily Life

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6. Have flooding or infrastructure issues caused any of the following impacts? (Select all that apply):

Poll question: 6. Have flooding or infrastructure issues caused any of the following impacts? (Select all that apply):. Select one or more options.
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7. During flooding events, are any of the following affected? (Select all that apply.)

Poll question: 7. During flooding events, are any of the following affected? (Select all that apply.). Select one or more options.
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Utilities and Home/Building Impacts

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8. Have you faced issues related to the following at home or your place of work? (Select all that apply.)

Poll question: 8. Have you faced issues related to the following at home or your place of work? (Select all that apply.). Select one or more options.
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General Feedback

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9. Are there any other water/ infrastructure related issues that you have faced?

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10. Is there anything else you would like to share with us?

Stay Involved

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