Barn Fire Survey Data October 2013 - October 2014

Please fill out the following survey on barn fires if you have any pictures or additional information that you want to share please email LegendAcres@hotmail.com

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* 1. What is your age?

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* 2. What is the highest level of school you have completed or the highest degree you have received?

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* 3. In what ZIP code was the Barn Fire located? (enter 5-digit ZIP code; for example, 00544 or 94305)

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* 4. Does anyone in your household own the business or farm that burned?

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* 5. What was the Date of the Barn Fire amd Approximate Time?

Date / Time

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* 6. Which of the following were in the barn?

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* 7. What was the extent of the loss?

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* 8. Cause of Fire (Arson, Electrical, Lightning, Unknown)

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* 9. How many of the following responded to the Fire and Name of Departments if possible?

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* 10. Extent of Damages

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