Water Point Sanitary Risk Survey e.g. for handpump borehole/well
|
Y/N
|
1. Cement floor extends less than 0.75 metre diameter?
|
|
2. Ponding of water on the cement floor?
|
|
3. Cracks in the cement floor which could permit water to enter the well?
|
|
4. Pump loose where attached to the base allowing water to enter the casing?
|
|
5. Ponding beyond the cement floor within 3 metres of the well?
|
|
6. Drainage channel cracked, broken or in need of cleaning?
|
|
7. Animals have access to within 10 m of the well?
|
|
8. Latrines, including old latrines, within 10 m of the well?
|
|
9. Additional latrines, including old latrines, within 30 m of the well?
|
|
10. Open water sources within 20 m of the well?
|
|
11. Uncapped wells within 30 m of the well?
|
|
12. Scattered waste within 30 m of the well
|
|
13. Waste dumps within 30 m of the well?
|
|
Shallow wells only (for boreholes mark as N)
|
|
14. Cover of the well insanitary?
|
|
15. Walls of the well inadequately sealed at any point below ground level?
|
|
16. Rope and bucket used?
|
|
Field Observations
|
|
Photos taken of the water point
|
|
Depth to groundwater table (mbgl)
|
|