Rainwater Club - Open well Survey Questionnaire

Open well Survey - Questionnaire

Date of visit / report
Investigator's Name
GPS location of well
Address of house


Dimensions of the well	Diameter (m)
	Depth (m)
Nature of the soil ( During excavation of well )
Age of the well
Level of water (Below ground level)	Before monsoon
	After monsoon
Quality		Odour Turbidity Colour Suspended solid
Use
Daily consumption (Litres)
Potential source of pollution		Septic tank Sewage line Others
Other source of water
Other information if any ( ex: Is a lake close by? Is it on a ridge?)