PLEASE USE A SEPARATE FORM FOR EACH FELT EARTHQUAKE.

Date of event:

Time of event: am pm

Location (town) where felt:

You were indoors outdoors driving not sure

Structure type: wooden masonry concrete other (decribe below) no building

Building type: single-story multiple-story other (describe below)

FOR THE COMPLETE DESCRIPTION OF INTENSITIES, GO TO http://hvo.wr.usgs.gov/earthquakes/felt/mercalli.html/

Select one that best describes your observations:

I Not felt; vibrations are recorded by instruments

II People at rest, upstairs, or in favorable places

III Felt indoors; hanging objects swing; may not be recognized as an earthquake

IV Dishes and doors rattle; standing cars rock; vibration like heavy trucks passing

V Felt outdoors; direction estimated; doors swing; liquid spills from glasses; sleepers awakened; unstable objects displaces

VI Felt by all; many frightened; people walk unsteadily; windows, dishes break; pictures fall off walls, items fall off shelves; furniture move

VII Difficult to stand; noticed by drivers; plaster, bricks, and tiles fall; large bells ring; waves on ponds, water turbid with mud

VIII Car steering affected; chimneys fall; branches break; cracks in wet ground; unbolten structures moved on foundations;

IX General panic; damage to foundations; sand and mud bubble from ground; unbolted structures shifted off of foundations; underground pipes broken

X Most masonry and frame structures destroyed; bridges destroyed; large landslides; water thrown out of rivers; rails bent slightly

XI Rails bend greatly; underground pipelines completely out of service

XII Damage nearly total; lines of sight and level distorted; objects thrown into the air

 

Please describe your observations and include additional comments:

Optional Information:

Name:

Telephone number or email address: