How long were you in this location? Record whether in minutes or hours. Were you inside or outside while you were there? If outside, skip questions In Out In Out In Out d, e, and f. If inside, were there any open windows Yes No Yes No Yes No while you were there? Unsure Unsure Unsure If inside, was there any ventilation, Yes No Yes No Yes No such as an [air conditioner/heater] Unsure Unsure Unsure running, while you were there? If respondent said “yes” for d or e, circle “no” for f and skip to next Yes No Yes No Yes No question. Otherwise, if inside, ask: Unsure Unsure Unsure did you shelter in place, meaning staying inside, with doors and windows closed and all ventilation systems turned off? If yes, ask the respondent: Please describe what you did to shelter in place. Did you smell an odor? If no or unsure Yes No Yes No Yes No skip questions h and i. Unsure Unsure Unsure Can you please describe the odor? Would you describe the odor as light, Light Moderate Light Moderate Light Moderate moderate or severe? Severe Severe Severe Were you in a [smoke cloud/dust/fog] Yes No Yes No Yes No while you were there? Unsure Unsure Unsure Did you evacuate from the highlighted area on the map? Yes No Go to Question A5 At approximately what time did you evacuate?
How long were you in this location? Record whether in minutes or hours. Were you inside or outside while you were there? If outside, skip questions d, e, and f. In Out In Out In Out If inside, were there any open windows while you were there? Yes No Unsure Yes No Unsure Yes No Unsure If inside, was there any ventilation, such as an [air conditioner/heater] running, while you were there? Yes No Unsure Yes No Unsure Yes No Unsure If respondent said “yes” for d or e, circle “no” for f and skip to next question. Otherwise, if inside, ask: did you shelter in place, meaning staying inside, with doors and windows closed and all ventilation systems turned off? If yes, ask the respondent: Please describe what you did to shelter in place. Yes No Unsure Yes No Unsure Yes No Unsure Did you smell an odor? If no or unsure skip questions h and i. Yes No Unsure Yes No Unsure Yes No Unsure Can you please describe the odor? Would you describe the odor as light, moderate or severe? Light Moderate Severe Light Moderate Severe Light Moderate Severe Were you in a [smoke cloud/dust/fog] while you were there? Yes No Unsure Yes No Unsure Yes No Unsure Did you evacuate from the highlighted area on the map? Yes No Go to Question A5 At approximately what time did you evacuate?
ACE_Adult_Survey.docx