University
of Minnesota, Morris
Earthquake Research Questionnaire
West Central Minnesota Earthquake of 06/04/93
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Name: |
Gender M or F? |
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Address: |
Age: |
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Phone #: (612) |
Survey #: |
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1. Location where earthquake effects were observed: |
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a. |
Where were you at the time of the earthquake? (get written description and plot location on map using survey number) |
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b. |
If you were in a house, on which floor? |
Basement |
first |
second |
third |
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What type of house? |
brick |
stone |
wood |
stucco |
mobile home |
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single story |
multiple story |
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c. |
If you were in a car, what type of road? |
gravel/dirt |
concrete |
tar |
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Was the car moving or standing still? |
moving |
standing still |
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d. Were you: |
sitting |
standing |
lying down |
other (specify) |
| 2. What did you observe? [Check any that apply] | ||||
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hanging objects swinging |
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vibrations like passing of trucks |
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standing motor cars rock |
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jolt like a heavy ball striking walls |
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windows, dishes, doors rattling |
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glasses clinking/crockery clashing |
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wooden walls or frame creaking |
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liquids disturbed or spilled |
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small objects displaced or upset |
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doors swinging closed, open |
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movement of pictures |
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glass or dishes broken |
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books off shelves |
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furniture moved |
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small bells ringing |
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trees or bushes shaken |
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hanging objects quiver |
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damage to masonry |
| 3. What other effects did you observe? |
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4. Estimate time in seconds of how long the earthquake lasted [in seconds]: |
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5. Was there any noise? [Yes or No]: |
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If yes, what was it like? |
e.g., a loud sharp noise like cannon fire |
yes |
no |
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a rumble like a train passing |
yes |
no |
| other (specify): |
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6. Have you noted damage to your house? |
yes |
no |
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a. cracked walls (interior) |
yes |
no |
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b. cracked walls (exterior) |
yes |
no |
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c. ripped/torn wallpaper |
yes |
no |
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d. cracked foundations or masonry |
yes |
no |
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e. other damage (specify): |
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7. Did you notice any other earthquake-like events before or after the main quake? |
yes |
no |
If yes, describe and estimate date and time (if not certain give time with AM or PM):
| 8. (asked of male/female pair) Who noticed the quake first? | man |
woman |
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9. What was your reaction to the earthquake? |
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anxiety |
apprehension |
concern |
confusion |
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fear |
indifference |
shock |
worried |
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10. How would you describe the reaction of others to the earthquake? |
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anxiety |
apprehension |
concern |
confusion |
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fear |
indifference |
shock |
worried |
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11. Other comments/observations: |
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12. Would you like a copy of the results of this survey? |
yes |
no |