In what city or town do you live?
a. 6 dys or more d. 4 dys/10 hr dys g. 2 dys or less
b. 5 dys e. 3 dys h. 9 dys/80 hrs
c. 4 dys f. 3 dys/12 hr dys
Hour Minutes Hour Minutes
Start am pm End am pm
Drive Alone Bicycle Telecommute
Carpool Vanpool (Working from home at least one day per week)
Bus Walk County vehicle
A- Electric B - Hybrid C - CNG/LPG D - N/A
Marie Frazier
31 N Pinal St Bldg F
Florence, AZ 85132
(520) 866-6037 (Direct)
(520) 866-6967 (Fax)
marie.frazier@pinalcountyaz.gov
Please return your survey by email, inter-office, or
fax.
(Print Clearly)
Air Quality/Travel Reduction
Name:
Date:
Department:
PRIZE INFO! We are currently offering $25 each to 20 (Twenty) employees that turn in their survey by the due date of
September 21, 2018. Complete the following to have your name entered. If you choose not to participate in the drawing,
please complete the above items and submit your survey.
The drawing will be held September 28, 2018.
5. If you participate in a carpool, how many other people(with a driver's license) travel with you to work?
6. How many miles (one-way) is it from your home to your worksite?
7. How many minutes (one-way) does it usually take you to travel from home to your worksite?
Pinal County Travel Reduction Survey 2018
1. Enter ONE letter that BEST describes the number of days per week you go to work at this site.
2. Enter your typical start and end time. (If times vary, enter your average start time/end time)
3. On average, how many days do you use each of these modes of transportation below to get to work in a given week?
DO NOT INCLUDE TRIP HOME!
Return to:
4. Enter one letter ONLY if the vehicle you typically use to drive to work uses one of the Alternative Fuel types below.
Department Name:
Return by:
Save survey after completing
and then return by email
Sept 21, 2018
Pinal County Travel Reduction 2018 Survey