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2. Question 1: Do you have Natural Gas Service in your home?*

   1. Yes
   2. No
4. Question 2: Did you know your natural gas provider's name is Natural Gas of Milton?*

   1. Yes
   2. No
6. Question 3: Have you heard or received inforamtion on natural gas safety from Natural Gas of Milton in the past 12 months?*

   1. Yes
   2. No
8. Question 4: Have you received written natural gas safety information with a gas bill in the past 12 months?*

   1. Yes
   2. No
10. Question 5: Have you heard natural gas safety information on the television or radio?*

    1. Yes
    2. No
12. Question 6: Have you read about natural gas safety information in local newspapers?*

    1. Yes
    2. No
14. Question 7: Do you think you would recognize a natural gas leak by being able to smell it?*

    1. Yes
    2. No
16. Question 8: Do you think you would reconize a natural gas leak by a hissing sound?*

    1. Yes
    2. No
18. Question 9: Would you light a match if you smelled gas inside your house?*

    1. Yes
    2. No
20. Question 10: Have you heard that you or an excavator company should call a central number prior to digging, to avoid accidententally hitting a natural gas pipeline?*

    1. Yes
    2. No
22. Question 11: Would you call 911 from outside or from a neighbor's house if you smelled gas inside your house?*

    1. Yes
    2. No
24. Question 12: Do you have the number to call Natural Gas of Milton if there as an incident or if you needed more information?*

    1. Yes
    2. No
26. Question 13: Would you like to hear the number to call Natural Gas of Milton if there as an incident or if you needed more information?*

    1. Yes
    2. No
28. Question 14: Do you believe that you have adequate information about natural gas safety like how to reconize a leak, what you should do if you smell gas in the home, etc?*

    1. Yes
    2. No
30. Question 15: Do you feel the natural gas industry has an adequate public awareness program overall?*

    1. Yes
    2. No
32. Thank you for taking the City of Milton's Natural Gas survey. Please fill in your name and either your eMail address or cell phone number for a chance to win a $100 gift card!
34. First Name*
35. Last Name*
37. eMail Address
38. Cell Phone Number
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40. 1. Receive an email copy of this form.
41. Email address

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42. Submit

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