505 – Site Assessment Form
Revised 09/2014
Site Assessment Checklist ............................................................................. 2
I) General Information ......................................................................................................... 2
1. Overview.................................................................................................................... 2
2. Logistical Support ...................................................................................................... 2
3. Problem Identification ................................................................................................ 2
4. Site Layout................................................................................................................. 3
5. Health and Safety Assessment Aspects .................................................................... 3
6. Material and Labor Availability and Costs .................................................................. 3
7. Financial Capacity of Community .............................................................................. 3
8. Organizational Capacity of Community ..................................................................... 3
9. Technical Capacity of Community ............................................................................. 4
10. Local Government
5
11. Environmental Aspects........................................................................................... 4
12. Socio-Cultural Aspects ........................................................................................... 4
13. Outcome Assessment Questions ........................................................................... 5
II) Water Projects ................................................................................................................. 6
1. Water Quality Testing ................................................................................................ 6
2. Supply/Distribution ..................................................................................................... 6
3. Water Treatment........................................................................................................ 7
III) Sanitation ....................................................................................................................... 8
1. Background Data ....................................................................................................... 8
2. Wastewater Management .......................................................................................... 8
3. Waste Treatment ....................................................................................................... 9
4. Construction, Collection and Conveyance ................................................................. 9
5. Environment ............................................................................................................ 10
6. Overall Considerations ............................................................................................ 10
IV) Construction Projects ................................................................................................... 11
1. Materials Availability/Testing ................................................................................... 11
2. Constructability Issues: ............................................................................................ 11
3. Loading .................................................................................................................... 11
4. Labor & Community ................................................................................................. 11
5. Bridges .................................................................................................................... 12
6. Buildings .................................................................................................................. 12
V) Energy .......................................................................................................................... 13
1. Solar ........................................................................................................................ 13
V) Recommended Reading ............................................................................................... 15
APPENDIX A – Various Forms for Data Collection ........................................................... 16
© 2014 Engineers Without Borders USA. All Rights Reserved
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I) General Information
The purpose of this document is to provide additional guidance to chapters on data that
they should collect during the assessment phase of their project. This checklist should be
used along with the instructions for the 521-Pre-Assesmsent Report and the 901 Program
Plan and Baseline Study for a complete understanding of all data that should be collected
and presented during the assessment phase.
Other guidance materials that are available on the Member Pages of the EWB-USA
website include EWB-USA Guidelines, EWB-USA Technical Webinars, Example
Submittals, Pre-Recorded Webinars, and links to various other technical resources that are
relevant to EWB-USA projects but were produced by other organizations.
1. Overview
a. What are the demographics of the community – total population, population density,
distribution in the town and vicinity, geographical size of community, proximity to
transportation?
b. What is the makeup of the community – ethnic groups, ages, economic status, work
force, community resources, political organization of the community, educational
level of the community and community leaders, language skills?
c. What social events should the chapter plan around (tribal holidays, Western
holidays, etc)?
d. What are the goals of the partnering NGO and what resources can they provide?
e. Are there other EWB-USA chapters in the region/country?
2. Logistical Support
a. Where will volunteers stay during trips to the community?
i. How many can comfortably be supported by the community?
ii. Where will volunteers eat; what water can they drink safely?
iii. Please keep in mind that large numbers of visitors put an undue burden on
the community
b. Contacts in the area or community that can be used throughout your program
i. Translators, skilled labor etc.
c. What are the different ways the community can contribute to the project, including
in-kind contributions?
i. A written Project Partnership Agreement may help define roles
3. Problem Identification
a.
b.
c.
d.
e.
What is the history of the problem/need?
If more than one need, what is the priority of the needs?
Have similar problems been addressed elsewhere?
Have other groups attempted to resolve the problem(s)?
Are there other appraisals available for this area (Peace Corps, NGOs) published,
web?
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4. Site Layout
a. Note status and location of all existing utility systems (water, wastewater, power,
phone) serving the community, if any, and sources
b. Obtain maps of the community (topographical, existing utilities, geographical, site
survey etc.)
c. Conduct surveying to fill any gaps in the locally available maps.
5. Health and Safety Assessment Aspects
a. Are there any specific safety risks (i.e. old land mines, political problems,
racial/religious conflicts) in the community?
b. Are there any specific safety climate risks (i.e. high altitude, temperature, insects)
that need to addressed?
c. Identify key contact information for emergency situations (i.e. hospital, US Embassy,
local community partner, local NGO partner)
d. What safety precautions are needed for implementation, such as trenching, pouring
concrete, electrical work, etc.?
e. What are the methods of safe transportation to /from the community?
f. Identify an emergency meeting point in the community
6. Material and Labor Availability and Costs
a. What hardware stores will be used during construction?
b. What is the quality of that material? For example, what type of pipe can be easily
purchased for construction of a water supply project and what is the pressure
rating?
c. What are the costs for those materials? The cost estimate for your design cannot
refer to U.S. material sources such as Home Depot.
d. Obtain cut sheets, specifications and/or pictures of key material that will be used for
your project.
e. How will the material be transported to the construction site? What is the additional
charge for material transport?
f. What skilled labor is available for the project and what are the costs? For example,
if an electrician will be needed, how much will they cost and what are their
qualifications?
7. Financial Capacity of Community
a. What is the primary form of income for residents in the community?
b. What bills and taxes do residents current play (electric, phone, water, etc.)?
c. What are residents willing to pay for operation and maintenance of implemented
infrastructure?
d. What are the ways the community raises funds for communal projects?
e. Have you confirmed that the community can contribute financially to the capital cost
of the project (a minimum of 5% is required of all EWB-USA projects).
f. What are the financial mechanisms for managing money for operation and
maintenance?
8. Organizational Capacity of Community
a. Is there an existing committee to manage this project and lead the eventual
operation and maintenance?
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b. Will this committee or specific maintenance people be responsible for operation
and maintenance?
c. Are there country- or region-specific norms around committee formation? For
example, many countries have a standard structure for water committees.
9. Technical Capacity of Community
a. Are the proposed technologies familiar to the community?
b. If the community does not have familiarity with the technology,are there neighboring
communities that do? Is the technology common in the region or country?
c. Are there local technicians familiar with the technologies being proposed?
10.
Local Government
a. What is the structure of the existing local municipal government?
b. Does the community have a local mayor and when is the next local mayoral
election?
c. Does the municipality or regional government have any engineering projects
planned for the community in the near future?
d. Are there any local laws or regulations that need to be followed?
11. Environmental Aspects
a. Where are project materials derived from; where is waste disposed? Does the
project encourage waste generation or natural resource depletion?
b. Does the project promote excessive material use and consumerism?
c. Are sensitive ecosystems being adversely impacted by the project, e.g. for a well
project: who will monitor the aquifer and watershed?
d. Would natural resources be conserved even if the project is widely adopted?
e. If the project was applied in all villages in the entire watershed/region, what could
happen?
f. If the project was used long-term, what impact is expected on the environment?
g. What is the end-of-life for the engineered product: is it biodegradable, non-toxic,
reusable?
12. Socio-Cultural Aspects
a. Does the EWB-USA project also help preserve indigenous culture and knowledge?
b. Are you capitalizing on existing indigenous knowledge?
c. Does the EWB-USA project support and respect the local cultural structures? Could
local traditions be interrupted or lost, e.g. TV is attributed to a decline in community
story-telling?
d. Do local social structures exist in the village to approve or veto a project of this
type? Are these local social structures and elders respected within the local
community?
e. Are there segments of society that may be marginalized by the project (they may not
necessarily have a voice)? How may they be integrated into the project?
f. Does the project preserve continuity and enhance self-reliance and self-image of the
community by integrating new technologies with existing successful traditions?
g. Are there regional or national governmental permits or approval needed?
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h. How do gender roles affect the successful implementation of the project?
13. Outcome Assessment Questions
a. Is the community aware of the anticipated engineering outcome of the project? Can
they assist in defining a metric for this and monitoring it?
b. Who among the community may be trained to gather data on project outcomes?
c. Who among the community is observant and would notice any unexpected negative
consequences of the project on the community or the ecosystem?
d. Are there any constraints that could impact the success of the project?
e. Develop a list of criteria to determine if the project is feasible
© 2014 Engineers Without Borders USA. All Rights Reserved
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II) Water Projects
1. Water Quality Testing
Refer to the Water Testing Guidance Sheet, which is available on the website under EWBUSA Guidelines, for direction on water quality assessment work.
2. Supply/Distribution
a. Supply/Demand analysis
i. What is the capacity of your source – dry season flow rates, productivity of
aquifer, rainfall?
ii. What is the demand now and in the future? Refer to the Estimating Average
Daily Demand Guidance Sheet, which is available on the website under
EWB-USA Guidelines.
b. Site topography for pipeline (elevation changes)
i. A good handheld GPS is only accurate to +/- 3ft in XY and +/- 10ft in Z at
best; see your owner’s manual for information on your GPS unit, a hand
level will provide better accuracy
ii. Make sure to check with a local university on the possibility of borrowing
surveying equipment and having students volunteer their time to help out
with the surveying
i. Whose land will the pipeline cross; are there any ownership rights that need
to be addressed
b. Water rights- who owns the water
c. Design flows - what are the current usage patterns. This data should be recorded
first-hand if possible as existing data is often times unreliable
d. Material availability
i. what type of pipes and valves are available (all materials must be available
locally)
ii. what is the maximum pressure for these pipes/valves
e. Tap locations
i. Where will the taps be located; how many people will use each tap
ii. Will taps be installed in households or in a central location
 If household taps are used, Chapter must consider wastewater
issues, impact of additional water usage, who gets water first, etc.
f. Wastewater
i. With more water, there is more wastewater, consider how will this be
treated/channeled; are there any additional health risks associated with this
water (i.e. Malaria)
g. Water source
i. River
 Who is downstream of the community that may be affected by this
diversion or water
 What are flows and water elevations during high and low flow
conditions
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ii. Spring:
 Is a spring box needed; what materials are available for the spring
box
 What does the spring look like in the low and high flow conditions
 Ownership of spring
 Does a tap need to reside on the spring box for people who used that
spring for watering their animals etc
iii. Groundwater (Wells)
 Are there wells in the area; how much do their water levels fluctuate
 What kind of pumping rates can be achieved
 What is the depth to potable water, is there more than one aquifer, is
the aquifer protected
 Who will monitor the well
 Distance to latrines in the area, surface water intrusion on the well
 Are there local drillers
3. Water Treatment
a. What kind of source water protection measures are possible
b. What materials are available locally; what are their costs?
i. Chlorine (are trained personnel available as well?)
ii. Sand or carbon filtration
iii. Pumice or gravels
iv. UV light bulbs; these contain mercury – how will they be disposed – UV
bulbs are rarely available locally, eliminating this technology as an option for
an EWB-USA project
v. Solar Disinfection (SODIS)— suitability of household rooftops and availability
of safe bottles. How will bottles be disposed?
b. What treatment technologies is the community familiar with
c. Technical skills of community – who is qualified to maintain treatment
d. Operational costs – can the community afford to operate and maintain treatment
system
c. Understanding of water supply system – supply/demand, elevations, flows, etc.
© 2014 Engineers Without Borders USA. All Rights Reserved
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III) Sanitation
1. Background Data
a. What is the source of the wastewater, i.e. toilets, washwater, greywater
b. Can sources of wastewater be segregated to simplify or reduce costs of
construction and maintenance
c. Source separation or segregation of wastes can reduce the volume of water
requiring treatment and the resulting expense and influence the type of treatment
needed to purify the water, for example:
i. Feces could be collected and separately treated in a pit or composting latrine
ii. Urine can be separated and beneficially used for fertilizer
iii. Greywater (water only used for washing dishes and bathing) may require
less treatment or a smaller treatment area that water bearing feces.
d. What quantities of waste (solid or water borne) will be generated; volume/mass of
feces and urine, as well as materials used for anal cleansing (paper, water, plant
materials, etc) need to be considered
e. All systems generate solid waste materials or biosolids - methods to collect and
reuse biosolids needs to be included:
i. What quantities of biosolids will be generated
ii. Are there adequate systems to collect the biosolids
iii. Can biosolids be composted?
iv. Have odors and vectors (flies and rodents), and contamination of storm
water been considered
v. Can the biosolids be beneficially used (applied to amend soils)
f. site topography for (elevation changes)
2. Wastewater Management
Both social and technical alternatives should be considered a. Social issues include:
i. The need for separate men’s and women’s facilities
ii. The locations of facilities and the ability of children to use the facilities
iii. Accessibility of the facilities
iv. It is possible to design a great system that will not get used, due to cultural
habits, taboos, fears and inconvenience
b. Technical alternatives to be considered and evaluated include, but are not limited to:
i. Pit latrine
ii. Ventilated pit latrines
iii. Composting latrines
iv. Water privy
v. Pour flush latrines
vi. Flushing toilets with treatment
 Septic tanks followed by soils based absorption systems (SBAS),
a.k.a. “leachfields”
 Media filters, e.g. textile, peat, sand
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 Recirculating sand filters (if pumps are available)
 Aerobic plants (require electricity)
 Sand filters (closed and open bottom)
 Constructed wetlands, overland flow
 Lagoons
c. For latrines consider the following:
i. The type of superstructure and materials to utilize
ii. Venting to control odors and enhance biodegradation of the feces and
evaporation of urine
iii. Insect and rodent proofing
iv. Adequate slope to drain away from the superstructure
v. Type of covering over the vault
vi. “squat plate”
vii. Depth, volume and lining for the pit
viii. Distance from water sources and wells
3. Waste Treatment
a. Water latrines and pour flush latrines rely upon treatment and dispersal of
wastewater into the surrounding soils
i. If the system will rely upon soil treatment (e.g. a “leach field”, pour flush
latrine, seepage pit), are the soil conditions and available area for infiltration
conducive to this type of treatment
ii. Subsurface conditions that impact performance and must be considered are:
 Soil types/percolations rates - soil can be classified using the U.S.
Department of Agriculture (USDA) textural triangle into sandy loams,
loams, and sandy clay loams or using the Unified Soils Classification
System (USCS) into SW, SC, CL, CH, etc. In areas where pan
evaporation exceeds precipitation for most months soils classified as
clays (CL, CH) may require large absorption systems or the use of an
evapotranspirative type of system; A quick percolation test can be
performed in possible disposal area(s)
 Depth to groundwater - a minimum of 12”-18” separation between the
infiltrative surface of the leach field and groundwater is required; if
depth to groundwater is unsatisfactory, a mound system may be
utilized, provided there sufficient quantity of fill soils to create a
mound
4. Construction, Collection and Conveyance
a. Are sufficient materials, labor, and equipment available to construct the components
of the treatment systems; for example:
i. Concrete and wood forms for a septic tank,
ii. Sand for sand filters
iii. Mortar and bricks for a seepage pit or vault.
iv. Piping to convey wastewater to the treatment system
v. Labor and equipment to excavate pits, pipeline trenches, leach fields
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vi. Wood or brick for privy superstructures
b. How much pipe will be required to convey the wastewater from the source to the
treatment system - the cost and labor of a system will increase significantly with
systems that require a lot of piping
i. Latrines require little piping,
ii. Septic tanks with SBAS may require more piping
iii. Lagoons and constructed wetlands may require even more pipe to deliver
the wastewater from the source to the treatment system
5. Environment
a. Will the system prevent or minimize contamination or further degrade the receiving
waters (surface lakes, streams and groundwater)
b. Is the level of treatment provided by the system sufficient to prevent degradation of
receiving waters
c. Can water be re-used for beneficial uses, e.g. crop irrigation
i. In areas with plenty of rainfall, reuse of the wastewater may not be worth
pursuing; however, in areas where water is scarce, reuse should be carefully
considered
ii. If wastewater will be re-used, the uses of the water will significantly influence
the degree of treatment and performance assurance of the system must be
carefully considered.
iii. If the water can be re-used, how will the water be stored and applied to
crops
d. Consider whether gas from biological treatment processes can be collected and
used for cooking and heating (biogas plant), possibly including animal waste
6. Overall Considerations
a.
b.
c.
d.
Is the project feasible from a social, economic, technical, standpoint
Is the project “buildable”
Have several alternatives been considered
The ideal solution for a project may require a single system, e.g. vault privy, while
other situations may require a combination of systems; several alternatives should
be considered following the site assessment
© 2014 Engineers Without Borders USA. All Rights Reserved
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IV) Construction Projects
Assuming some sort of structure is being contemplated, such as: water tanks, buildings of any sort,
culverts, bridges, pole support structures, modifications to existing structures, etc.
1. Materials Availability/Testing
a. What building materials are readily available; keep in mind that it is not enough to
just know if ready-mixed concrete is available, you also have to form the concrete so
are forming material (i.e. plywood) must be available
b. Are local materials available such as sand, gravel, or wood
c. Can you ascertain the strengths of the available building materials? I.E. grade of
reinforcing bars, strength of concrete mix, grade or strength of concrete masonry
blocks, grade or strength of corrugated metal panels, etc.
d. Materials cannot be assumed to be the strength in text books
i. Conservative estimate for concrete strength is 2300PSI if it is mixed by hand
ii. All rebar should be tested for large construction
e. Can materials be reproduced by others
2. Constructability Issues:
a. Can materials be delivered to a remote site
b. If heavy equipment of any kind (backhoe) is required, where will it be obtained
c. Can concrete trucks access the site and be emptied in 90 minutes; hot, windy
weather will shorten this time
d. Where are materials going to be stored and stockpiled
e. How will materials be protected from rain and/or theft
f. Is testing necessary; if so, how will this be done
g. What will you do with waste
h. What is the condition of the road to the site; is it useable by cargo vehicles
i. Is power available for using powered equipment
3. Loading
a. If your structure will generate even moderate loadings to the soil, can you determine
some of the soil’s properties in order to make a valid judgment about the allowable
soil bearing pressure
b. Can you make valid assumptions about the environmental loadings to your structure
such as for wind and seismic
4. Labor & Community
a. Depending on the type of structure you are contemplating, does the community
have the skills to assist you with the construction and learn from you and then be
able to replicate this type of construction
b. Contemplate and evaluate the potential for future expansion to your proposed
structure; plan and design for this, if needed, from the very start
c. What is the common construction method for houses in the country, i.e. masonry,
concrete, adobe, etc
d. Are technicians available from the local government or NGO’s for the project
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e. Take photos of site from various angles for reference later; photos of other
construction techniques in city or villages will be helpful later.
5. Bridges
a. For sophisticated structures such as a bridge or culvert crossing, you must have
team members that are well versed in obtaining the detailed information for the
bridge or culvert crossing. These detailed items include:
i. Stream hydrology
ii. Highest level of flooding
iii. Scour-out protection
iv. Roadway alignment
v. Detailed foundation study/evaluation
vi. Vehicle loading
vii. Impact loading
viii. Construction sequencing
b. Survey longitudinally for bridge sites; check high flow and erosion problems up
stream
6. Buildings
a. Dimensions
b. Location
© 2014 Engineers Without Borders USA. All Rights Reserved
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V) Energy
1. Solar
a. The following primary guidelines MUST be considered for the assessment of any
solar project:
i. The risk of theft and vandalism is inherent to any solar project. As such,
many NGO’s have a policy of not implementing solar projects in developing
communities. Chapters must develop a comprehensive plan for mounting
and securing panels in order to prevent theft and damage
ii. The brand and model of panel being installed must be available from an incountry distributor. Additionally, all maintenance and replacement materials
must be available locally including mounting, sealant and electrical
equipment.
iii. A cost-benefit analysis must be carried out for all energy alternatives.
b. Other considerations:
i. What equipment will be powered—is this considered a basic need?
ii. What is the needed kWh output and how will this vary throughout the year
What is the latitude and longitude of the community
iii. How will the output of the system vary throughout the year
iv. How many cloudy days
v. What equipment is available locally
vi. Where will the solar panels be placed
 What angle will result in maximum efficiency
 Can the panels be roof mounted or will some sort of ground mount be
needed
 What materials are available for this
 For roofs: can the roof support a worker’s weight, what reinforcement
will be needed for the roof so that the panels can be mounted
 Is there any shading (even a very small amount of shading can
severely reduce the panel’s output – make sure to read about this)
 If there is shading, can the obstruction be removed (i.e. cut down the
tree), is yes, who will do this and what impact will it have
vii. Distance from the panels to the batteries or grid tie
viii. How will the power be routed to the batteries, converters, loads
c. Batteries
i. Where will the batteries be stored
 What ventilation is available (the build up of hydrogen gas is a
hazard)
 How will they be secured against damage and theft
ii. How will the batteries be disposed; batteries contain undesirable materials
such as lead and cadmium that would be harmful if they leaked into water
supplies
iii. How many days of backup are needed
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iv. What batteries are available locally for replacement; at what cost:
batteries are going to be the main maintenance cost for the system, and it
has to be affordable for the community or the system will simply stop working
when the batteries fail in 3-5 years.
d. Grid connected
i. Who is the AC electrician who will connect this system to the grid
ii. What is the demarcation point going to be
iii. What type of metering is available
e. Who will be in charge of maintenance
i. Is distilled water available for the batteries
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V) Recommended Reading
1) Field Guide to Appropriate Technology by Christopher Bull and Barrett Hazeltine
2) Engineering in Emergencies by Jan Davis and Robert Lambert
3) EWB-USA Guidelines by various EWB-USA Technical Advisory Committee members.
Available on the EWB-USA website
© 2014 Engineers Without Borders USA. All Rights Reserved
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APPENDIX A – Various Forms for Data Collection
© 2014 Engineers Without Borders USA. All Rights Reserved
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Construction
Project Location:
GPS ID:
Longitude
Latitude
Elevation
Tool
Shovel
Hammer
Wheelbarrow
Screen
Wire
Trowels
Buckets
Pick
Screw Drivers
Saws
Transportation
Jeep
Pickup Tuck
3t truck
5t truck
Porter
Access Road
Map/Directions:
Date:
deg
deg
(ft or m?)
min
min
Cost / Unit
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
Cost / Day or Distance
/
/
/
/
/
type, condition
© 2014 Engineers Without Borders USA. All Rights Reserved
sec
sec
Material
Cement
Lime
Sand
Gravel
Rock
Screen
Wire
Metal Roofing
Reinforcing Bars
Wood
Paint
Nails
Screws
Bolts
Glass
Labor
Unskilled Lborer
Skilled Laborer
Technician
Engineer
Other
Notes:
Cost / Unit
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
Cost/Day
/
/
/
/
/
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TOPOGRAPHY/GEOLOGY
Project Location:
GPS ID:
Longitude
Latitude
Elevation
Geology:
Date:
deg
deg
(ft or m?)
min
min
sec
sec
Notes:
Maps or Reference:
General Notes on Terrain & Vegetation:
Map:
© 2014 Engineers Without Borders USA. All Rights Reserved
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WELL
Project/Location:
GPS ID:
Longitude
Latitude
Elevation
Date:
deg
deg
(ft or m?)
min
min
GENERAL CONDITIONS
Depth to Groundwater
(high/low if seasonal)
Depth to Top of Sediments
Depth of Sediments in Well
Diameter of Well
sec
sec
Notes:
WATER QUALITY
Units
(ft or m?)
(ft or m?)
(ft or m?)
(ft or m?)
pH
Alkalinity
Chlorides
NH3
Nitrate
mg/L
mg/L
mg/L
mg/L
Nitrite
mg/L
Units
Copper
Lead
Mercury
Arsenic
Hardness
Coliform
Bacteria
SOIL PROFILE: Describe Soil/Rock Subsurface
USE:
How Many People Use the Well?
Does the Well Go Dry/When?
What is Proximity of Livestock?
Well Priority (high/med/low)?
Can the aquifer support this use?
Who will monitor the aquifer?
Can the wellhead be protected?
ADDITIONAL NOTES:
NOTES:
© 2014 Engineers Without Borders USA. All Rights Reserved
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mg/L
mg/L
mg/L
mg/L
mg/L
MPN
505 – Site Assessment Form
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LATRINE
Project/Location:
GPS ID:
Longitude
Latitude
Elevation
Date:
deg
deg
(ft or m?)
min
min
sec
sec
Notes:
GENERAL CONDITIONS
Diameter of Latrine
Depth to Top of Waste
Depth of Latrine
Percolation Rate of Soil?
(ft or m?)
(ft or m?)
(ft or m?)
min/in
SOIL PROFILE:
Describe Soil/Rock Subsurface:
USE:
How Many People Use the Latrine?
What is the Level of Waste in Latrine?
Do Women/Men/Children Use Latrine?
Distance/Direction to Well?
Well Priority (high/med/low)?
Wind Direction? Who will smell it?
NOTES:
ADDITIONAL NOTES:
© 2014 Engineers Without Borders USA. All Rights Reserved
Page 20 of 22
505 – Site Assessment Form
Revised 09/2014
SURFACE WATER
Project/Location:
GPS ID:
Longitude
Latitude
Elevation
Date:
deg
deg
(ft or m?)
min
min
sec
sec
Notes:
WATER QUALITY
Units
pH
Alkalinity
Chlorides
NH3
Nitrate
mg/L
mg/L
mg/L
mg/L
Nitrite
mg/L
Pollutants:
VOCs
µg/L
Notes:
Copper
Lead
Mercury
Arsenic
Hardness
Coliform
Bacteria
TPH
Pesticides
Units
mg/L
mg/L
mg/L
mg/L
mg/L
MPN
mg/L
µg/L
MAP:
© 2014 Engineers Without Borders USA. All Rights Reserved
Page 21 of 22
505 – Site Assessment Form
Revised 09/2014
RIVERS/STREAMS
Project/Location:
Date:
Name of Water Body:
GPS ID:
Longitude
Latitude
Elevation
deg
deg
(ft or m?)
min
min
sec
sec
Notes:
RIVER/STREAM:
Width
Depth
Velocity
Flow Rate
m
m
m/s
m3/s
WATER QUALITY
Units
pH
Alkalinity
mg/L
Chlorides
mg/L
NH3
mg/L
Nitrate
mg/L
Nitrite
mg/L
Sketch Cross Section of River/Stream:
Notes:
Copper
Lead
Mercury
Arsenic
Hardness
Coliform
Bacteria
Units
mg/L
mg/L
mg/L
mg/L
mg/L
MAP:
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Page 22 of 22