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* 1. What is your agency's name?

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* 2. What is your agency's address?

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* 3. What is your agency's county/area of jurisdiction?

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* 4. Who is your agency's department chief?

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* 5. What is your agency's telephone number?

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* 6. What is your agency's email address?

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* 7. Name of the person completing this survey.

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* 8. Signature

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* 9. Date

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* 10. Does your agency have firefighting equipment (i.e. firetrucks, foam) suitable for oil, gas, liquid petroleum, or any other type of pipeline fires?

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* 11. If answered YES above, please describe the number and type of firetrucks and/or equipment.

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* 12. Has your agency ever responded to a pipeline incident?

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* 13. Has your agency received other pipeline safety training?

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* 14. In the event of a pipeline emergency, would your agency respond?

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* 15. Does your agency have personnel trained to respond to oil, natural gas, liquid petroleum and other types of pipeline fires?

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* 16. Does your agency have personnel certified as Hazardous Materials (HAZMAT)/Hazard Waste Operations and Emergency Response (HAZWOPER) responders?

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* 17. Does your agency have a public evacuation plan?

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* 18. Can your agency provide communications and assistance with public evacuation?

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* 19. Does your agency have a hazardous spill contingency plan?

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* 20. Do you understand your role in the event of a pipeline emergency?

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* 21. Does your agency utilize the Incident Command System (ICS) in an emergency?

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* 22. Is your agency familiar with the 811 system?

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* 23. If you would like to request contact from an Enable Midstream Partners representative, please state the subject matter you would like to discuss and best contact email or phone number.

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