Field Survey Format ( Sewerage & Solid Waste Management )
Equicity, Nagpur
( All India Institute of Local Self Government )
INTERVIEW DATASHEET - (YEAR 2017)
Ref. No. Interviewer Date
Locations Postal Address
Zone Prabhag
Sewerage & Sanitation ( Outcomes )
1. Level of Services
1.1 What kind of Toilet facility do Individual Household latrine Community Others
members of your household usually Toilet /
use? Public
Toilet
1.2 Is your Household Toilet Yes No
connected to the sewerage system
(observation/random community
interaction) ?
1.2.1 If (Yes), Open Close
Type of Drainage
1.3 What is the distance between your 1 toilet 1 toilet within 1 toilet No toilet
house and Public/Community Toilet within 100 300 meters within 500 within 500
meters meters meters
1.4 Is the Community/Public Toilet Yes No
connected to the sewerage
system(observation/random
community interaction) ?
1.2.1 If (Yes), Yes No
Type of Drainage
1.5 Does the Community/Public Toilet Yes No
include separate Male-Female Toilets
?
1.6 Basic infrastructure functional in Excellent Good Average Poor
the Public/Community toilet (taps,
pour flush, door, wash basin etc.
(observation/random community
interaction)
2. Level of Cleanliness
2.1 Do people of your area defecate Yes No
/urinate in the open
(observation/random community
interaction)
2.2 How would you rate the Excellent Good Average Poor
maintenance/cleanliness of
Public/Community toilet ?
3. Responsiveness to Consumer Complaints ( Based on Citizens Survey )
3.1 Have you made a complaint Yes No
related to Sewerage & Sanitation
service in the past one year?
3.2 What was the time taken to Within Within a week More than Never
respond to your complaint ? One day a week
3.3 How would you rate supervisors V. Good Good Average Impolite/
behaviour in dealing with Public ? /Polite Rude
3.4 How would you rate the efficiency Excellent Good Average Poor
of the repair and maintenance of the
staff ?
3.5 Have you paid a bribe for any Yes No
service related to Sewerage &
Sanitation service in the last one
year?
4. Overall Satisfaction of Citizens with Services (Based on Citizens Survey)
4.1 How would you rate the Sewerage Excellent Good Average Poor
& Sanitation service in your locality
area?
Solid Waste Management ( Outcomes )
5. Level of Services (In Residential Areas/Public Areas/ Slums)
5.1 What is the Frequency of Daily Once in 2 days Once in 3-4 Once in a
sweeping and cleaning in your area ?. days week
5.2 What is the frequency of Door to Daily Once in 2 days Once in 3-4 Once in a
door waste collection from your days week
household ?
5.3 Availability of collection bins at Adequate no. of bins placed Inadequate No Bins.
appropriate places ? per commercial area
5.4 Do you separate different type of Yes No
waste before giving it to the waste
collector ?.
5.5 Do the waste collector maintain Yes No
the separation of waste while
collecting ?.
6. Level of Cleanliness (In Residential Areas/Public Areas/ Slums)
6.1 No visibility of solid waste in your 100% area 75% area 50% area <50% area
area clean clean clean clean
6.2 Visibility: Waste transfer Well Well Neither maintained nor
stations/Tippers/Bins maintained maintained painted
and but not
painted painted
6.3 Is the Size of the bins sufficient Yes No
enough to manage daily waste (No
Spill over) ?
7. Responsiveness to Consumer Complaints ( Based on Citizens Survey )
7.1Have you made a complaint Yes No
related to Solid Waste Management
service in the past one year?
7.2 What was the time taken to Within Within a week More than Never
respond to your complaint ? One day a week
7.3 How would you rate supervisors V.Good Good Average Impolite/Ru
behaviour in dealing with Public ? /Polite de
7.4 How would you rate the efficiency Excellent Good Average Poor
of the repair and maintenance of the
staff ?
7.5 Have you paid a bribe for any Yes No
service related to Solid Waste
management service in the last one-
year?
8. Overall Satisfaction of citizens with services ( Rating from Citizen Survey )
8.1 How would you rate the Sewerage Excellent Good Average Poor
& Sanitation service in your locality
area?