1.  What is the name of your community?

2.  What is the population of your community?

3.  How many trains per day pass through your area?

4.  How did you arrive at this figure? Local Railroad Authority Physical Count Just A Guess

5.  How many railroad crossings do you have in or within 1/2 mile of your community?

6.  At how many of these crossings are train horns sounded?

7.  Who has jurisdiction for the roadway at each of these crossings? (Please indicate the number of crossings for each.) Municipal County    State

8.  How many of these crossings have multiple tracks?

9.  List the identification information displayed on the control box at each crossing:

10. Do you feel that train horn noise affects the quality of life of the residents or businesses of your community? YES   NO

11. Do you feel it is worth spending public funds to curtail the sounding of train horns? YES   NO

12. It is feasible to close some crossings in your community and re-route traffic to other crossings to reduce train horn noise? YES   NO

13. Approximately how many people are affected by train horn noise in the vicinity of you community?

14. Are you familiar with Railroad Quiet Zones? YES   NO

15. This form completed by:  Name   City Position 

Please list any comments you might have: