Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Untitled Page

  • Project Location
  • Site name

  • Wereda

  • Kushet

  • Tabia

  • GPS northing

  • well ID

  • Project type and status information

  • date/month of construction/Rehablitation

  • Project Type

  • If rehabilitation, month/year of break down

  • Does the water scheme has appropriate fence and lock

  • for how long was the water scheme nonfunctional

  • Current beneficiaries number

  • Type of breakdown

  • Institutional strength and WASHCO related information

  • is there a guard. Does the water scheme have a bank account

  • if yes how much

  • what amount of deposit does the water scheme has currently. Is there any fee to use water

  • is it ratified?

  • , are they trained

  • what is their sex composition

  • Do they have a bylaw?

  • Is there a functional WASHCO

  • what is their number

  • Water quality related information

  • pleasant/unpleasant, if any color

  • physical taste of the water

  • Is there any quality issue seen/faced in the water supply

  • Sanitation related information

  • is there any water stored around the well

  • Is there appropriate drainage system

  • Is there anyone who took sanitation and hygiene training by this program from health staffs of the Tabia?

  • Other supplies

  • What other supplies were supplied to community members like dignity kit, water treatment chemical etc

  • WASHCO members

  • Wider scheme view and people collecting water

  • Close view showing the plaque

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