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  • Survey Before The Implementation of The Device Survey Before The Implementation of The Device

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    Antonio Farparan
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    This survey collects information from respondents about their current drinking water sources and usage before implementing a new device. It asks about available and used water sources, distance to sources, fetch frequency and time. It also asks if sources have broken down recently, and how often. Finally, it seeks agreement to implement a water pump and filtration system in the area.

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    SURVEY

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    This survey collects information from respondents about their current drinking water sources and usage before implementing a new device. It asks about available and used water sources, distance to sources, fetch frequency and time. It also asks if sources have broken down recently, and how often. Finally, it seeks agreement to implement a water pump and filtration system in the area.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    7 views1 page

    Survey Before The Implementation of The Device Survey Before The Implementation of The Device

    Uploaded by

    Antonio Farparan
    This survey collects information from respondents about their current drinking water sources and usage before implementing a new device. It asks about available and used water sources, distance to sources, fetch frequency and time. It also asks if sources have broken down recently, and how often. Finally, it seeks agreement to implement a water pump and filtration system in the area.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    SURVEY BEFORE THE SURVEY BEFORE THE

    IMPLEMENTATION OF THE DEVICE IMPLEMENTATION OF THE DEVICE


    A. A. Drinking Water B. A. Drinking Water
    Which of the following sources of drinking Which of the following sources of drinking
    water are available in your neighbourhood? (Multiple water are available in your neighbourhood? (Multiple
    responses are possible) responses are possible)
    Bore well/ hand pump Bore well/ hand pump
    Public tap Public tap
    Community well Community well
    Household water supply (piped) Household water supply (piped)
    Others. Be specific: __________ Others. Be specific: __________

    Which of the following sources of drinking Which of the following sources of drinking
    water does your household use? (Multiple responses water does your household use? (Multiple responses
    are possible) are possible)
    Bore well/ hand pump Bore well/ hand pump
    Public tap Public tap
    Community well Community well
    Household water supply (piped) Household water supply (piped)
    Others. Be specific: __________ Others. Be specific: __________

    How far (in meters) is the water source ______ How far (in meters) is the water source ______
    that you use? that you use?

    How often would you like to get ______ How often would you like to get ______
    water? water?

    How long (in minutes) does it take to ______ How long (in minutes) does it take to ______
    fetch water and return home? fetch water and return home?

    Has the water source broken down in YES Has the water source broken down in YES
    the past one year? NO the past one year? NO

    How frequently has it broken down? ______ How frequently has it broken down? ______

    Is the public tap fixed promptly when YES Is the public tap fixed promptly when YES
    it breaks down? NO it breaks down? NO

    Disagree Neutral Agree


    Disagree Neutral Agree

    Do you agree to implement


    Do you agree to implement
    Water Pump in your area?
    Water Pump in your area?
    Do you agree to implement
    Do you agree to implement
    Water Filtration in your area?
    Water Filtration in your area?
    ___________________________________________
    ___________________________________________
    Respondent’s Signature
    Respondent’s Signature

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