(Please fill out each of the three forms, including the
Registry Form and the Special Skills/Equipment/Resources
e-mail (if available): _________________________
IF ENGLISH IS YOUR SECOND LANGUAGE, DO YOU NEED HELP
THIS QUESTIONNAIRE AND OTHER EMERGENCY PREPARATION
IS YOUR HOUSEHOLD PREPARED?
1. Is your house/apartment building bolted and
2. Is your house/apartment building made of unreinforced
3. Is your waterheater strapped down (potential fire
4. Are your heavy furniture items (such as book shelves)
(bolted to studs in the wall)?
5. Do you have at least a 3-day supply of water (plan on one
per person, per day)
6. Do you have an emergency food supply?
7. Do you have a first aid kit?
8. Do you want help in evaluating/securing your home?
FOR APARTMENT DWELLERS (WITH MORE THAN 2 UNITS)
1. Are you willing to serve as a contact person for your
2. Name of Landlord:____________________________________
Landlord's Phone Number: ___________________________
DEVELOPING A NEIGHBORHOOD EMERGENCY PLAN
1. Are you willing to attend any planning meetings scheduled
NOT ABLE TO NOW, BUT KEEP ME INFORMED___
2. Are you interested in joining any of the following
response teams? (check one--see attached pages describing
Sheltering and Special Needs___
Search and Rescue___
3. Were you unable to attend the CORE training, but
receiving copies of training materials?
4. Would you like to attend a CORE training in the
5. Do you have space in a structurally sound garage or other
that you would be willing to make available as our
command post, a place where we can store central supplies,
gather after an earthquake and organize response teams?
6. Are you willing/able to make a financial contribution
towards purchasing tools and supplies that would serve the
neighborhood in a disaster? (for example, ham radio,
hard hats, radios, flashlights, bulletin boards, walkie
7. Are you willing to assist a neighbor in
his/her home (for example, evaluate state of foundation,
book cases to the studs in walls, review safety measures,
8. Are you willing to serve as a "disaster buddy" to a
with special needs (for example, someone with a physical
9. Would you like to be included in a phone tree to be
about special events?
10. Would you be willing to help make phone calls and/or
notices about special events and planning meetings?
ORGANIZING BLOCK PARTIES
During times of distress it is easier to work with friends
acquaintances than with strangers. Block parties--aside from
a lot of fun (as those who attended the 44th Street block
last September can testify)--can help to build friendly
associations that will make preparing for an earthquake a
easier. Please indicate whether you would like to work on
the following committees to plan another block party on 44th
(or on your block):
Check here if you have a special musical talent, and would
willing to perform___
Any other concerns you'd like to express:
Copyright City of Oakland 1993
The neighborhood earthquake committees are still in the
process of forming, so no one is officially "in charge" yet,
but if you have questions or concerns about the
questionnaire or about the emergency plan, please feel free
to contact any of the following people who participated in
the CORE trainings:
44th Street * Sally Thomas, 471-44th (658-9673)
Laura Jackson (601-1580)
Howard Lasseter (601-6729)
Gloria Cobb (428-0827)
45th Street * Tom Wenzel, 416-45th (601-0574)
Patrick Hickey (428-7633)
Webster Street * Cathy Steirn, 4415 Webster (547-3193)
John Goodwin (655-6727)