Copy of Economic Impact from Severe Weather San Benito County

Question Title

* 1. Please enter your first and last name

Question Title

* 2. What is your business name?

Question Title

* 3. Please enter your email address.

Question Title

* 4. Please enter a contact phone number.

Question Title

* 5. How was your business affected by the severe storm?

Minimal

Moderate

Extreme/ Severe

Question Title

* 6. Did you experience any loss of the following items? (Please select all that apply)

Crop Loss

Infrastructure (Roads, fencing, greenhouses, buildings)

Equipment (Irrigation system, electric systems, pumps, etc.)

Ag Use Vehicles (Ranch/Farms Trucks, Tractors)

Livestock

Other

Question Title

* 7. Estimate the loss value in US $ from each category.

Crops

Infrastructure

Equipment

Ag Use Vehicles

Livestock

Other

Question Title

* 8. If applicable, please enter the approximate crop acres planted.

Question Title

* 9. If applicable, please enter the approximate crop acres damaged.