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144 A p p e n d i x H Prototype Freight and Service Trip Generation Survey
145 Phone number: Is this the headquarters of the firm? Full time Part time Total employees in a typical day (office + others) Total office staff in a typical day Is the work done at the premises performed in shifts? Total number of employees per shift: Total site area* * Specify units (e.g., sq. yds, sq. ft, acres) Number of floors of the main building occupied by the firm: Notes: (1) Include leased vehicles. See the diagram of vehicle types in the next question. (2) If you do not know the answer fill it in using "n/a" Cars: 4 or fewer axle single-trailer trucks: Small pickups/vans: 5 axle single or multi-trailer trucks: 2 axle single unit trucks: 6 or more axle single or multi-trailer trucks: 3 or 4 axle single unit trucks: others/ not specified: YES NO Is your establishment the only one at this site? NO YES SITE AND GROSS FLOOR AREA N/A Information you provide here will be kept confidential and will be used for planning purposes only Name: Address: ZIP: CONTACT INFORMATION FOR THE PERSON COMPLETING THE SURVEY Name: Position: E-mail: Nature of business: Restaurants Building materials Establishment Floor Area* Apparel/Accesory store Other: Freight Trip Generaï¿½on Study ESTABLISHMENT INFORMATION Food store NUMBER OF PEOPLE CURRENTLY EMPLOYED AT THIS ADDRESS BUSINESS ACTIVITY TYPE OF ESTABLISHMENT YES NO City: State: NUMBER OF VEHICLES OPERATED FROM THIS ADDRESS BY TYPE
146 Other / Don't know per day per week per day per week per day per week Other / Don't know 2 axle single unit trucks Cars Small pickups/vans per day per week address RECEIVED AT this address Time unit Large trucks Quantity Unit (e.g., tons, lbs) Type of cargo produced Description per day Quantity Unit (e.g., tons, lbs) Type of cargo received per week per day per week per day per week NUMBER OF SERVICE TRIPS WITH THIS ADDRESS AS ORIGIN OR DESTINATION BY VEHICLE TYPE NUMBER OF DELIVERY TRIPS WITH THIS ADDRESS AS ORIGIN OR DESTINATION BY VEHICLE TYPE per week per day Small pickups/vans per day per week TRIPS RELATED TO SERVICES TRIPS RELATED TO GOODS AND SUPPLIES Time unit RECEIVED AT this address (deliveries to establishment) MADE FROM this address (deliveries to customers) Example TYPE OF CARGO PRODUCED AND RECEIVED BY THE ESTABLISHMENT Description 2 axle single unit trucks Cars If you would like more information about the survey, please contact Mr. xxxxx (email@example.com) at his/her e-mail address or call xxx-xxx-xxxx In the table below, provide the average number of service trips PER DAY/ PER WEEK (e.g., cleaning the windows) In the table below, provide the average number of deliveries PER DAY/ PER WEEK (e.g., office supplies and food) Example If no information is available use "n/a". If the answer is zero use "0" If no information is available use "n/a". If the answer is zero use "0" LEAVING this