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Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme Questionnaire for ''Completed Hand Pump / Tube well Schemes'' Page 1 of 3 National Rural Drinking Water Programme (NRDWP) Monitoring of 'Completed Hand Pump / Tube well' by Institutional NLMs Questionnaire Sl No. Particulars Options 1. General Information of the scheme: a. Scheme ID (As per IMIS): b. Name of the Scheme (As per IMIS): Name : 1 State 2 District 3 Block 4 Village 5 Habitation c. Year of Completion of the Scheme as per IMIS: Year : d. Year of Completion of the Scheme :(Surveyor to reconfirm it from ground report) Year : e. Type of the Scheme (As per IMIS): 1 Single Village 2 Multi Village f. Type of the Scheme (As per ground report): 1 Single Village 2 Multi Village g. Coverage as per 40 lpcd (As per IMIS) 1 Fully covered (FC) 2 Partially covered (PC) 3 Quality affected (QA) h. Actual supply level (lpcd)
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Page 1: National Rural Drinking Water Programme (NRDWP ......Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme Questionnaire for ''Completed Piped Water supply

Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme

Questionnaire for ''Completed Hand Pump / Tube well Schemes'' Page 1 of 3

National Rural Drinking Water Programme (NRDWP)

Monitoring of 'Completed Hand Pump / Tube well' by Institutional NLMs

Questionnaire

Sl No.

Particulars Options

1.

General Information

of the scheme:

a. Scheme ID (As per IMIS):

b. Name of the Scheme

(As per IMIS):

Name :

1 State

2 District

3 Block

4 Village

5 Habitation

c. Year of Completion of the Scheme as per IMIS:

Year :

d.

Year of Completion of the Scheme :(Surveyor to reconfirm it from

ground report)

Year :

e. Type of the Scheme (As per IMIS):

1 Single Village

2 Multi Village

f. Type of the Scheme (As per ground report):

1 Single Village

2 Multi Village

g. Coverage as per 40

lpcd (As per IMIS)

1 Fully covered (FC)

2 Partially covered (PC)

3 Quality affected (QA)

h. Actual supply level (lpcd)

Page 2: National Rural Drinking Water Programme (NRDWP ......Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme Questionnaire for ''Completed Piped Water supply

Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme

Questionnaire for ''Completed Hand Pump / Tube well Schemes'' Page 2 of 3

i. Who bears the O & M of the Scheme ?

1 State Govt. Dept.

2 Govt. Corporation

3 Gram Panchayat

4 Village Water and Sanitation Committee (VWSC)

5 Combination of above

j.

Whether water tariff is collected from the beneficiaries ?

1 Yes

2 No

If Yes: Yearly Tariff charges in Rs. Per households

k. Nos. of tube wells installed for the scheme

l. Nos. of Handpumps installed under the scheme

m. Total Nos. of defunct handpumps or tube wells

n.

Access for School?

1 Yes

2 No

What is the satisfaction level ? (give brief details)

Whether whole year water is supplied ? 1 Yes

2 No

o.

Access for Sub Centre / health centre?

1 Yes

2 No

What is the satisfaction level (give brief details)

Whether whole year water is supplied ? 1 Yes

2 No

p.

Access for Aganwadies?

1 Yes

2 No

What is the satisfaction level (give brief details)

Whether whole year water is supplied? 1 Yes

2 No

q.

Is there any mechanism to monitor misuse of

water at the nearby stand post of the water distribution centre?

1 Yes

2 No

If Yes at above

Is there any attempt to sensitize to stop misuse of water?

1 Yes

2 No

r.

Is there any awareness programme about water conservation among the villagers?

1 Yes

2 No

If No at above

Is there any attempt to spread awareness through the authority?

1 Yes

2 No

Page 3: National Rural Drinking Water Programme (NRDWP ......Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme Questionnaire for ''Completed Piped Water supply

Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme

Questionnaire for ''Completed Hand Pump / Tube well Schemes'' Page 3 of 3

2. Functionality

of the scheme

a. Reason for Tube wells

Not Working

1 Electricity Problem

2 Spare Parts problem

3 Mechanic not attending the complaint

4 Source has dried or water table has gone down which is beyond the capacity of pump installed

b. Reason of Hand Pump

Not working

1 Water table gone down

2 Bad smell / colour / mud laden water coming out from hand pump

3 Riser pipe choked , hand pump body damaged

4 Spare parts not available

5 No proper maintenance by

PHED / RPWS dept. / GP

6 Natural calamity struck and subsequently not repaired

3. Water

Quality aspects

a. Water Quality aspects

1 What is colour of the water supplied?

2

Is there any odour

of the water supplied?

1 Yes

2 No

3

Is there any laboratory to test the quality of

water?

1 Yes

2 No

If YES, Whether water is contaminated?

1 Yes

2 No

If YES:

1 Arsenic

2 Fluoride

3 Any other

4. Overall

rating of the scheme

a.

Overall rating of the scheme considering the perception of the

public in general

1 Good

2 Average

3 Not Satisfactory

********

Page 4: National Rural Drinking Water Programme (NRDWP ......Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme Questionnaire for ''Completed Piped Water supply

Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme

Questionnaire for ''Completed Piped Water supply Schemes'' Page 1 of 3

National Rural Drinking Water Programme (NRDWP)

Monitoring of ''Completed Piped Water supply Schemes'' by Institutional NLMs

Questionnaire

Sl No.

Particulars Options

1.

General Information

of the scheme:

a. Scheme ID (As per IMIS):

b. Name of the Scheme (As per

IMIS):

Name :

1 State

2 District

3 Block

4 Village

5 Habitation

c. Year of Completion of the Scheme

as per IMIS: Year :

d.

Year of Completion of the Scheme :(Surveyor to reconfirm it from

ground report) Year :

e. Type of the Scheme (As per IMIS): 1 Single Village

2 Multi Village

f. Type of the Scheme (As per

ground report):

1 Single Village

2 Multi Village

g. Source type for the scheme (As

per IMIS)

1 Ground Water

2 Surface Water

3 Combination of both

h. Source type for the Scheme : (As

per ground report)

1 Ground Water

2 Surface Water

3 Combination of both

i. Coverage as per 40 lpcd (As per

IMIS)

1 Fully covered (FC)

2 Partially covered (PC)

3 Quality affected (QA)

j. Actual supply level (lpcd)

Page 5: National Rural Drinking Water Programme (NRDWP ......Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme Questionnaire for ''Completed Piped Water supply

Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme

Questionnaire for ''Completed Piped Water supply Schemes'' Page 2 of 3

k. Who bears the O & M of the

Scheme ?

1 State Govt. Dept.

2 Govt. Corporation

3 Gram Panchayat

4 Village Water and Sanitation Committee

(VWSC)

5 Combination of above

l.

Whether water tariff is collected from the beneficiaries ?

1 Yes

2 No

If Yes: Yearly Tariff charges in Rs. Per households

2.

Functionality and

Sustainability of the Scheme:

a. Is the PWS scheme is functional ? 1 Yes

2 No

If Yes at above Then, Water availability:

b.

For Fully Covered (FC) habitations (Minimum 40 LPCD*

for FC habitations)

1 Around the Year

2 Part (months) of the year

3 Break down % (due to reasons other than source dry)

c. For Partially Covered (PC)

habitations

1 How many months household gets water ?

2 Total Nos. of public standposts in the scheme. (Nos.)

3 Non- functional stand-post existing (Nos.)

4 Missing Taps in stand post existing (Nos.)

5 How many house hold connections are there in the scheme ?

d. Approx. how much % age of people get water within 100 metre

distance of their households from the source ?

e.

Access for School?

1 Yes

2 No

What is the satisfaction level ? (give brief details)

Whether whole year water is supplied ?

1 Yes

2 No

Page 6: National Rural Drinking Water Programme (NRDWP ......Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme Questionnaire for ''Completed Piped Water supply

Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme

Questionnaire for ''Completed Piped Water supply Schemes'' Page 3 of 3

f.

Access for Sub Centre / health centre?

1 Yes

2 No

What is the satisfaction level (give brief details)

Whether whole year water is

supplied ?

1 Yes

2 No

g.

Access for Aganwadies?

1 Yes

2 No

What is the satisfaction level (give brief details)

Whether whole year water is supplied?

1 Yes

2 No

h.

Is there any mechanism to monitor misuse of water at the nearby stand post of the water

distribution centre?

1 Yes

2 No

If Yes at above

Is there any attempt to sensitize to stop misuse of water?

1 Yes

2 No

i.

Is there any awareness programme about water

conservation among the villagers?

1 Yes

2 No

If No at above

Is there any attempt to spread

awareness through the authority?

1 Yes

2 No

If 'No' at 2.a (i.e. if PWS scheme is non-functional)

j. Non-functional since how many days ? days

k. Reason for Non functionality of

the PWS scheme

1 Paucity of funds for O & M

2 Non payment of electric Charges

3 Non availability of

manpower

4 Electricity issue

5 Drying of Source

6 Pumping system failure

7 Distribution (piping) failure

8 Water treatment failure

3. Overall

rating of the scheme

a. Overall rating of the scheme

considering the perception of the public in general

1 Good

2 Average

3 Not Satisfactory

***********

Page 7: National Rural Drinking Water Programme (NRDWP ......Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme Questionnaire for ''Completed Piped Water supply

Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme

Questionnaire for Ongoing Piped Water supply Schemes Page 1 of 3

National Rural Drinking Water Programme (NRDWP)

Monitoring of ''Ongoing Piped Water supply Schemes'' by Institutional NLMs

Questionnaire

Sl No.

Particulars Options

1.

General Information

of the scheme:

a. Scheme ID (As per IMIS):

b. Name of the Scheme (As

per IMIS):

Name :

1 State

2 District

3 Block

4 Village

5 Habitation

c. Year of start of the

Scheme as per IMIS: Year :

d.

Year of start of the Scheme :

(Surveyor to reconfirm it

from ground report)

Year :

e. Type of the Scheme (As

per IMIS):

1 Single Village

2 Multi Village

f. Type of the Scheme (As

per ground report):

1 Single Village

2 Multi Village

g. Source type for the

scheme (As per IMIS)

1 Ground Water

2 Surface Water

3 Combination of both

h. Source type for the

Scheme : (As per ground report)

1 Ground Water

2 Surface Water

3 Combination of both

i.

Coverage proposed as

per 40 lpcd (As per IMIS) :

1 Fully covered (FC)

2 Partially covered (PC)

3 Quality affected (QA)

j. Actual supply level (in lpcd, in case when part of the scheme is

complete and providing water)

k.

Who would bear the O & M of the Scheme ?

1 State Govt. Dept.

2 Govt. Corporation

3 Gram Panchayat

4 Village Water and Sanitation Committee (VWSC)

5 Combination of above

Page 8: National Rural Drinking Water Programme (NRDWP ......Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme Questionnaire for ''Completed Piped Water supply

Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme

Questionnaire for Ongoing Piped Water supply Schemes Page 2 of 3

l.

Whether water tariff would be collected from the beneficiaries ?

1 Yes

2 No

If Yes: information on planned Yearly Tariff charges in Rs. Per households

2. Completion status of the

scheme a.

MILESTONES OF COMMISSIONMING

OF SURFACE WATER BASED

PIPE WATER

SUPPLY SCHEME

AC

TIV

ITIE

S

i. Lift Station / Intake Well / Infiltration well

1 Yes

2 No

ii.

Raw water conveying

/ Rising Main (upto RWR)

1 Yes

2 No

iii. Construction of raw water reservoir (RWR)

1 Yes

2 No

iv. Water Treatment Unit 1 Yes

2 No

v. Main Supply Pipes 1 Yes

2 No

vi. Pipe Distribution network

1 Yes

2 No

vii.

Commissioning of

entire system and handing over to PRI

1 Yes

2 No

Overall physical completion of the ongoing scheme? (as per the enclosed Physical achievement indicator format number 1)

3.

Functionality and

Sustainability of the

Scheme (if part of the ongoing

scheme is completed

and providing

water): This portion is not to be filled if

none of the habitation planned

under the schemes are benefitted with water

supply

a. Is any segment or part of the PWS scheme is functional:

1 Yes

2 No

If Yes at above Then, Water availability:

b.

For Fully Covered

(FC) habitations (Minimum 40 LPCD*

for FC habitations)

1 Around the Year

2 Part (months) of the year

3 Break down % (due to reasons other

than source dry)

c. For Partially Covered

(PC) habitations

1 How many months household gets water ?

2 Total Nos. of public standposts in the scheme. (Nos.)

3 Non- functional stand-post existing (Nos.)

4 Missing Taps in stand post existing (Nos.)

5 How many house hold connections are there in the scheme ?

d. Approx. how much % age of people get water within 100 metre

distance of their households from the source ?

Page 9: National Rural Drinking Water Programme (NRDWP ......Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme Questionnaire for ''Completed Piped Water supply

Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme

Questionnaire for Ongoing Piped Water supply Schemes Page 3 of 3

e. Planned Access for

School ?

1 Yes

2 No

What is the satisfaction level? (give brief details)

f. Planned Access for Sub Centre / health

centre?

1 Yes

2 No

What is the satisfaction level (give brief details)

g. Planned Access for

Aganwadies?

1 Yes

2 No

What is the satisfaction level (give brief details)

h.

Is there any mechanism in planning to monitor misuse of water at the nearby stand post of the water distribution

centre?

1 Yes

2 No

If Yes at above

Is there any attempt to sensitize to stop misuse of water? 1 Yes

2 No

If 'No' at 3.a (any segment or part of the PWS scheme is non-functional:)

i. Reason for delay

1 Lack / Paucity of funds

2 Non availability / Possession problems of land

3 Disputes while laying pipeline below / over ground

4

Statutory clearances / permissions unavailable from respective authorities.

5 Material not available / material out of production.

6

Transport problems / inaccessibility

due to inclement weather / natural calamity.

7 Contractual problems including arbitration and litigations / public unrest and protests.

8 Non acceptance of tenders / Zero response.

9 Partial acceptance of tenders / uncompetitive bidding by contractors / agencies.

10 Source related problems

4. Overall rating of

the scheme a.

Overall rating of the scheme progress considering the

perception of the public in general

1 Good

2 Average

3 Not Satisfactory

********

Page 10: National Rural Drinking Water Programme (NRDWP ......Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme Questionnaire for ''Completed Piped Water supply

Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme

Enclosure for the NRDWP NLMs Questionnaire Page 1 of 1

*Approximately 4 buckets per person per day may be considered as 40 litres. Note: In each village at least 50% of the responders should consists of women. The responders and surveyors should be captured in pictures with PWS scheme in the

village. Legends: § PC- Partially Covered, FC - Fully Covered and QA- Quality Affected § IMIS- Integrated Management Information System § MoDWS- Ministry of Drinking Water & Sanitation (www.mdws.gov.in) § LPCD- litres per capita per day § O & M- Operation and Maintenance § PHED- Public Health Engineering Department, GP- Gram Panchayat § VWSC- Village Water & Sanitation Committee, PHC- Primary Health Centre, SC - Sub centre "There can be instances when the visited scheme is not complete but is yielding water. The

incompleteness is due to ancillary facilities such as boundary wall or fencing or finishing works or any other minor works. If the scheme is supplying water to the beneficiary population then the scheme may be termed as completed. There can be instances when the schemes is supplying water to more than one village as in the case of multi village scheme. In such a case if the scheme is not supplying water to all beneficiaries, an approximation may be made in ratio of the beneficiaries benefitted to the total number of beneficiaries.

In some cases it may happen that there exists a gap in the time when some of the schemes

are completed on ground and giving water supply and the date of its completion as found in IMIS. This may happen due to procedural delays and may have to be suitably adjusted. In case of Single Village Scheme, a relaxation of 3 months of mismatch is permitted and in case of multi village scheme a relaxation of 6 months in the mismatch is permitted.

Further percentage completion of any ongoing scheme can be worked out using the format 1:

a to c as per the annexure included herewith. In the format, the important markers of the physical progress are tabulated.

Additionally, any scheme is said to be nonfunctional if it is not bearing water for a

contiguous period of more than 30 days, provided further that no major R&M works such as source augmentation or pump replacement or Rising main replacement or such other major over hauls are in progress.

Additional comments and opinion of the beneficiary / public at large may be scribbled by NLM so that qualitative aspects and overall satisfaction of the public may be assessed.

Page 11: National Rural Drinking Water Programme (NRDWP ......Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme Questionnaire for ''Completed Piped Water supply

Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme

Format Number- 1(a)

PHYSICAL ACHIEVEMENT INDICATOR FOR SURFACE WATER BASED PIPE WATER SUPPLY SCHEME

Activities

Allocation of weightage for

completion

Weightage accrued on actual

completion (representative

completion)

Overall Percentage

of Each component

A

Lift Station/ Intake Well / Infiltration well 25 9 36.00 %

1 Construction of Intake Well + pumphouse 8 6

2 Installation of pumping machineries (M & E)

10 0

3 Approach walkway (if part of design) 5 2

4 Energisation of machineries 2 1

B

Raw water conveying / Rising Main (upto RWR)

5 2 40.00 %

1 Excavation for laying pipe 2 1

2 Laying of pipeline 2 1

3 Testing of rising / conveying main 1 0

C

Construction of raw water reservoir (RWR) 8 4 50.00 %

1 Civil works for RWR 6 3

2 Hydro Test and Raw water main connection

2 1

D

Water Treatment Unit 35 14 40.00 %

1 Aeration unit & Primary Settling tank 5 2

2 Clariflocculator 5 3

3 Filter House 10 4

4 Disinfection unit (Chlorination unit etc.) 5 3

5 Filtered Water Reservoir Civil work & testing

10 2

E

Supply Main (from treatment to habitation) 9 4 44.44 %

1 Excavation of trench for Supply main 3 2

2 Laying of Supply Main and testing 4 2

3 Installation of metering point in Supply

main

2 0

F

Distribution network 16 4 25.00 %

1 Distribution pipe network within

habitation

4 1

2 Reservoirs (GLR, OHT etc.) 7 3

3 Standpost Connection 2 0

4 House connection 3 0

G Commissioning of entire system and handing over to PRI

2 0 0.00 %

H Overall physical completion 100.00 % 33.63%

Page 12: National Rural Drinking Water Programme (NRDWP ......Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme Questionnaire for ''Completed Piped Water supply

Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme

Format Number- 1 (b)

PHYSICAL ACHIEVEMENT INDICATOR FOR CONTAMINATED GROUND WATER

BASED PIPE WATER SUPPLY SCHEME

Activities

ALLOCATION OF WEIGHTAGE FOR COMPLETION

WEIGHTAGE ACCRUED ON ACTUAL COMPLETION (Representative Completion)

OVERALL PERCENTAGE OF EACH COMPONENT

A

Tube well & pump house 25 7 28.00 %

1 Construction of Tube Well 10 6

2 Installation of pumping

machineries (M & E)

10 0

3 Energisation of machineries 5 1

B

Raw water conveying / Rising Main (upto RWR)

8 2 25.00 %

1 Excavation for laying pipe 3 1

2 Laying of pipeline 3 1

3 Testing of rising / conveying main 2 0

C

Construction of raw water reservoir (RWR)

10 4 40.00 %

1 Civil works for RWR 7 3

2 Hydro Test and Raw water main

connection

3 1

D

Water Treatment Unit 30 5 16.67 %

1 Geogenic contamination removal 13 3

2 Disinfection unit (Chlorination unit

etc.)

17 2

E

Supply Main 9 4 44.44 %

1 Excavation of trench for Supply

main

3 2

2 Laying of Supply Main and testing 4 2

3 Installation of metering point in

Supply main

2 0

F

Distribution network 16 4 25.00 %

1 Distribution pipe network within habitation

4 1

2 Reservoirs (GLR, OHT etc.) 7 3

3 Standpost Connection 2 0

4 House connection 3 0

G Commissioning of entire system and handing over to PRI

2 0 0.00 %

H Overall physical completion 100.00 % 25.59%

Page 13: National Rural Drinking Water Programme (NRDWP ......Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme Questionnaire for ''Completed Piped Water supply

Ministry of Drinking Water and Sanitation National Rural Drinking Water Programme

Format Number- 1 (c)

PHYSICAL ACHIEVEMENT INDICATOR FOR GROUND WATER BASED PIPE WATER SUPPLY SCHEME

Activities

ALLOCATION OF WEIGHTAGE FOR COMPLETION

WEIGHTAGE ACCRUED ON ACTUAL COMPLETION (Representative

Completion)

OVERALL PERCENTAGE OF EACH COMPONENT

A

Tube well & pump house 25 7 28.00 %

1 Construction of Tube Well 10 6

2 Installation of pumping machineries (M

& E)

10 0

3 Energisation of machineries 5 1

B

Raw water conveying / Rising Main (upto RWR)

14 2 14.29 %

1 Excavation for laying pipe 6 1

2 Laying of pipeline 6 1

3 Testing of rising / conveying main 2 0

C

Construction of raw water reservoir (RWR) 15 4 26.67 %

1 Civil works for RWR 10 3

2 Hydro Test and Raw water main

connection

5 1

D Water Treatment Unit 15 2 13.33 %

1 Disinfection unit (Chlorination unit etc.) 15 2

E

Supply Main 10 5 50.00 %

1 Excavation of trench for Supply main 3 2

2 Laying of Supply Main and testing 5 2

3 Installation of metering point in Supply main

2 1

F

Distribution network 19 4 21.05 %

1 Distribution pipe network within habitation

5 1

2 Reservoirs (GLR, OHT etc.) 8 3

3 Standpost Connection 2 0

4 House connection 4 0

G Commissioning of entire system and handing over to PRI

2 0 0.00 %

H Overall physical completion 100.00 % 21.91%

*************


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