2016 Mosquito Control Questionnaire Question Title * 1. What is the name of your city, town or county? w 0 (Required.) Question Title * 2. What is your population? w 0 (Required.) Question Title * 3. Do you currently conduct mosquito control activities?(if mosquito control is contracted out please list their name so we may forward this survey to them to fill out) w 0 (Required.) yes no Contractor Question Title * 4. Please list contact information for the person responsible for mosquito control in your area w 0 (Required.) Name Position/Title Address Office # Cell # Email Question Title * 5. What department does mosquito control fall under? w 0 (Required.) emergency management public works streets, water, sewer Other (please specify) Question Title * 6. What mosquito control activities do you currently practice? (Check all that apply) w 0 (Required.) treat standing water spray truck source reduction (clear ditches, tires, etc.) provide educational materials none If you currently practice source reduction please list what is done? Question Title * 7. Is the primary purpose of your mosquito control program to (check all that apply): w 0 (Required.) control nuisance mosquitoes prevent disease transmission Other (please specify) Question Title * 8. Does your jurisdiction have "clean up" or roll off dumpster days? w 0 (Required.) yes no Other clean up activities (please specify) Question Title * 9. Do you check for the presence of mosquito larvae before you treat standing water? w 0 (Required.) yes no we don't treat standing water Question Title * 10. If you treat standing water for mosquito larvae do you keep records of when and where you treat? w 0 (Required.) yes no Question Title * 11. What month do you begin spraying for adults each year? w 0 (Required.) January February March April May June July August September October November December Other (please specify) Question Title * 12. How do you decide when to start and end spraying for the year? w 0 (Required.) Question Title * 13. How do you decide where to spray? w 0 (Required.) Question Title * 14. Do you keep records of when and where you send a spray truck? w 0 (Required.) yes no Question Title * 15. What time of day do you begin spraying? w 0 (Required.) 2 hours prior to dusk 1 hour before dusk at dusk 1 hour after dusk Other (please specify) Question Title * 16. On average, how many hours does 1 truck spray per day? w 0 (Required.) 1 hour 2 hours 3 hours 4 hours 5 hours Other (please specify) Question Title * 17. How many truck mounted sprayers do you use? w 0 (Required.) 1 2 3 4 5 6 or more Question Title * 18. How often do you calibrate your truck-mounted sprayers? w 0 (Required.) Question Title * 19. Do you keep records of how much chemical you use? w 0 (Required.) yes no Question Title * 20. List the name(s) of the chemicals you currently use? w 0 (Required.) Question Title * 21. How long have you used the above listed chemicals? w 0 (Required.) Question Title * 22. Please check the type of chemicals you use: (select all that apply) w 0 (Required.) Oil based Water based Ready to use Question Title * 23. Do you rotate the chemicals you use for adult mosquitoes? w 0 (Required.) yes no Question Title * 24. Do you use any other adulticiding equipment, if so please check all that apply w 0 (Required.) Hand-held foggers (ulv or thermal) Gas-powered backpack sprayers We spray with trucks only Other (please specify) Question Title * 25. Do you keep a complaint log? w 0 (Required.) yes no Question Title * 26. In the event of local Zika transmission does your program have the ability to do the following: (please check the box if you have the listed ability) w 0 (Required.) Ability to perform resistance testing Ability to go door to door to distribute educational materials Ability to go door to door and hand fog homeowners yards Ability to arrange a clean up or roll off dumpster activity Ability to apply barrier treatments with backpack sprayers Aside from money what would limit your ability to perform any of the above listed tasks (please specify) Done