Questionnaire

2. Check off the name of you community or stakeholder group:

   1. Anderson Springs
   2. Blue Lakes
   3. Buckingham
   4. Clearlake
   5. Clearlake Oaks
   6. Clearlake Riviera
   7. Cobb
   8. Coyote Valley
   9. Double Eagle
   10. The Geysers
   11. Glenhaven

   1. Harbin Hot Springs
   2. Hidden Valley Lake
   3. Kelseyville
   4. Kono Tayee
   5. Lake Pillsbury
   6. Lakeport
   7. Little Valley
   8. Loch Lomond
   9. Lower Lake
   10. Lucerne

   1. Middletown
   2. Morgan Valley
   3. Nice
   4. Riviera Heights
   5. Riviera West
   6. Soda Bay
   7. Spring Valley
   8. Twin Lakes
   9. Upper Lake
   10. Witter Springs
4. Do you participate in any of the following?

   • Firewise Communities
   • Fire Safe Council
   • Emergency response neighborhood
   • Online fire/safety/inspection group

   1. Yes

   1. No
6. Name of group, if any?
8. Email Contact
10. Other Contact
14. Read the list of fire safety activities below and check off what you or your group are actively doing:
16. Reducing Forest Fuels

    1. Selective thinning of trees
    2. Removing ladder fuels
    3. Planning or performing prescribed burning
    4. Managing forest health
18. Reducing Home or Structure Vulnerability

    1. Undertaken assessment of home/structure flammability
    2. Created/maintained home defensible space
    3. Had recent inspection(s) by an outside agency
20. Partnership/Collaboration

    1. Working with other entities
    2. Looking out for at-risk neighbors
22. Education Outreach

    1. Public meetings
    2. Field trips
    3. Demonstration projects
    4. Household visits
    5. Youth engagement
    6. Community events
    7. Other
23. If "Other", please specify:
25. Emergency Management

    1. Looking out for vulnerable neighbors
    2. Planning evacuations
    3. Preparing animal and livestock evacuations
    4. Creating or maintaining safety zones or temporary refuge areas (TRAs)
    5. Developing or maintaining communication systems
    6. Developing or maintaining Emergency Resource lists
27. Comments or details you would like to share about any of these activities:
31. Provide the names and contact information for any other groups or people not already listed whose work you think is important to fire safety in the county:
33. Name 1
34. Contact Information
36. Name 2
37. Contact Information
39. Name 3
40. Contact Information
Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

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