Smoking Vehicle Program Compliance Questionaire

The Smoking Vehicle Program is a voluntary citizen participation program. No enforcement action is taken as a result of citizen complaints against smoking vehicles. In order for the District to determine the effect of this program, and to consider improvements, we request that you take a few minutes to complete this survey.

* indicates mandatory field

Reference Number (6 digit code): *
1. On the reported date, were you the owner of this vehicle?
Yes No, I never owned it No, I have already sold it *
2. Was the vehicle being driven in the location and on the date shown in this letter?
Yes No I don't know *

If you answered No to questions 1 or 2, we regret that you were contacted in error.
Please stop here and click the "Submit" button so that we may correct our records.
3. On the reported date, was the vehicle smoking?
Yes No I don't know
4. Prior to receiving this letter, were you aware of the smoke emissions from this vehicle?
Yes No

5. What was causing the excessive smoke emissions? (Mark all that apply)
Fuel-rich mixture (carburetor, air filter, fuel system, choke, etc.)
Burning Oil
Other Leak Fluids (coolant, transmission fluid, headgasket failure, etc.)
Other Cause
I don't know
6A. Was the vehicle repaired? (If yes, please answer 6B and 6C below.)
Yes No

  6B. Were repairs made after receiving this letter?
   Yes No

  6C. What was the cost of repairs?
   $

7. Did you take any other actions to address the problem? (Mark all that apply)
Removed vehicle from operation
Sold vehicle
Scrapped or junked vehicle
Began using more public transportation
Unable to take action due to lack of funds
Other
8. Comments: (255 characters limit)