• General Response Form
• Customer Satisfaction Survey
• Performance Survey
• Flood Survey




 
 
    Survey Form - Flood Survey
  Briefly describe your feedback regarding the service that you have received from the Division of Water Pollution Control.
Choose an answer by checking the appropriate box :
1. Number of times basement flooding has occurred in my home in the past three years:
Never 4-7 times
1-3 times 8 or more
2. When basement flooding occurs, it occurs:
During and/or just after rainstorms
During dry weather
3. When basement flooding occurs, the water enters the basement:
Thru the sanitary floor drain
Thru the walls and/or floor slabs
4. When basement flooding occurs, the water level in the basement rises approximately:
0-1 feet above the basement floor
1-4 feet above the basement floor
More than 4 feet above the basement floor
5. When basement flooding occurs, the basement remains flooded for approximately:
Less than 1 hour 10-24 hours
1-5 hours More than 24 hours
5-10 hours  
6. When basement flooding occurs, the water in the basement is:
Clear with minimal odor Muddy with strong odor
Muddy with minimal odor  
7. When basement flooding occurs, I notify the City of Cleveland:
Every time Never
Some of the time  
8. When basement flooding occurs, it is typically relieved by:
Snaking the house connection
Opening a blocked street main by City crews
It will go away after a period of time
9. Number of times the street has flooded in the past five years:
Never More than 5 times
Less than 5 times  
 
Personal Details
Fields marked with asterisk (*) are mandatory.
Contact Name
Address *
Phone
Email *
 
 
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