REFUGEE WATER SUPPLY INVENTORY FORM
Date:..../..../....
Country:................................................................ Camp:...........................................
Location:.............................., ................................, ...................................................
State/province |
District |
Locality |
Source Name:................................
Sketch Location Map Drafted by:...................................
Scale: |
Present Use:
Unused
Unprotected
Abandoned
Protected
Other
(specify):................................
Observations:..........................................
Location by Coordinates:
Latitude:
Longitude:
Elevation (metres above sea level):
Measurement device:
Altimeter
Theodolite
Estimate
Other (specify)
TYPE OF SOURCE:
Surface water |
Groundwater |
Other (specify): | |
Lake |
Spring |
......................................... | |
Pond |
Sump | ||
Swamp |
Dug well | ||
River |
Tube well | ||
Creek |
Infiltration Gallery | ||
Other
(specify):................. |
Other
(specify):................. |
DESCRIPTION OF EXISTING WATER SUPPLY AND WATER USE (actual or potential) of this source within the system: (use additional pages, if required)............................................................
REFUGEE WATER
SUPPLY
Source:...........................................................
INVENTORY
FORM
Date:..../..../.... Camp:.......................................... Identification (name or number)..............................
Elevation (metres above sea level)...............
Description of source:
Type........................
Type of water catchment structures (if any) (include drawings, sketches, etc. as annexes):...................
Description of existing water supply and water use (actual or potential) of this source within the system:..................
Water quality and quantity:
Description of general conditions and factors affecting water
quality and quantity.
Include, as annexes, laboratory or field records on
quality tests and a summary of volumes/yields measurements with significance for
productivity and reserve calculations:..................
REFUGEE WATER SUPPLY SURFACE WATER SOURCES INVENTORY FORM
Date:..../..../.. Source
name:.................
Camp:........... Elevation (metres above sea
level)............................
Type:..........................
YIELD ASSESSMENT CHART | ||||
Measurement Number |
Date |
Flow Measurement (Litres per Second) |
Measuring Device |
Performed by |
1 | ||||
2 | ||||
3 | ||||
4 | ||||
5 | ||||
6 |
WATER QUALITY ASSESSMENT CHART* | ||||||||||||||||||||
Analysis Number |
Date |
Physical Characteristics (specify units of
measure) |
Chemical Characteristics (milligrammes per
litre) | |||||||||||||||||
Colour |
Odour |
Turbidity |
Suspd Solids |
pH |
Elec. Conduct |
Alkalinity |
Total Hardn |
- |
-2 |
- |
-2 |
- |
- |
+2 |
+2 |
+ |
+ |
+3 | ||
F |
Description of potential or present use (include possibilities and constraints for further development): ...................................................................
Include, as annexes, all laboratory or field analysis reports, including bacteriological data.
REFUGEE WATER SUPPLY SPRING WATER SOURCE INVENTORY FORM
Date:..../..../.. Spring
name:..................
Camp:........... Elevation (metres above sea
level):...........................
Type:..............................
YIELD ASSESSMENT CHART | ||||
Measurement Number |
Date |
Flow Measurement (Litres per Second) |
Measuring Device |
Performed by |
1 | ||||
2 | ||||
3 | ||||
4 | ||||
5 | ||||
6 |
WATER QUALITY ASSESSMENT CHART* | ||||||||||||||||||||
Analysis Number |
Date |
Physical Characteristics (specify units of
measure) |
Chemical Characteristics (milligrammes per
litre) | |||||||||||||||||
Colour |
Odour |
Turbidity |
Suspd Solids |
pH |
Elec. Conduct |
Alkalinity |
Total Hardn |
- |
-2 |
- |
-2 |
- |
- |
+2 |
+2 |
+ |
+ |
+3 | ||
F |
Hydrogeological setting (include a hydrogeological sketch, if possible, as an annex): .................................
Description of potential or present use (include possibilities and constraints for further development: .............................................
Include, as annexes, all laboratory or field analysis reports, including bacteriological data.
REFUGEE WATER SUPPLY LARGE DIAMETER WELL SOURCE INVENTORY FORM
Date:..../..../.... Camp:..............................
Well
number:......................
Well
name:.......................
Construction Date:.../..../....
Elevation
(metres above sea
level)............................
Constructor:.........................
WELL LOG | |||||
Depth (metres) |
Geological Log (graphic) |
Design Log (graphic) |
Geolog. Log Descriptive |
Design Log Descriptive |
Pumping Tests* |
Type: |
* Pumping test measurements must be included as annexes.
Description of casing and filter elements:.....................
Description of well head design (including apron, sanitary seals, drains):.......................
Observations:.....................................................................................
Pumping test measurements should be included as annexes.
REFUGEE WATER SUPPLY BOREHOLE SOURCE INVENTORY FORM
Date:..../..../....
Camp:.......................................... Borehole
number:.............
Borehole name:....................
Drilling
Date:..../..../....
Elevation (metres above sea
level)...................
Driller:.................................
Rig/drilling technique:.............
BOREHOLE LOG | |||||
Depth (m) graphic |
Geological Log (graphic) |
Design Log (graphic) |
Geolog. Log Descriptive |
Design Log Descriptive |
Pumping Tests* |
Step drawdown: |
* Pumping test measurements must be included as annexes.** If measurements made in observation wells, add location maps, design log, pumping test data and any other relevant information as annex.
*** Laboratory or field water quality analysis reports should be added as annexes.
Description of casing: diameters:..................................................... Material:...............
Description of screens: diameters:................................................... Material:...............
Slot openings:..........................................................................................
Description of gravel pack:.......................................................................................................
Description of well head design (include description of apron and sanitary seal):...................
Observations:.............................................................................................................................
REFUGEE WATER SUPPLY BOREHOLE SOURCE INVENTORY FORM
Borehole Number:....................
Elevation (metres above
sea
level)..................................
Camp:......................................
STATIC WATER LEVELS RECORD | |||||||||||
Date |
Measurement Device |
Reference Point |
S.W.L. |
Date |
Measurement Device |
Reference Point |
S.W.L. |
Date |
Measurement Device |
Reference Point |
S.W.L. |
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PHYSICO-CHEMICAL WATER QUALITY ASSESSMENT
CHART* | ||||||||||||||||||||
Analysis Number |
Date |
Physical Characteristics (specify units of
measure) |
Chemical Characteristics (milligrammes per
litre) | |||||||||||||||||
Colour |
Odour |
Turbidity |
Suspd Solids |
pH |
Elec. Conduct |
Alkalinity |
Total Hardn |
- |
-2 |
- |
-2 |
- |
- |
+2 |
+2 |
+ |
+ |
+3 | ||
1 |
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2 |
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3 |
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4 |
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3 |
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6 |
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7 |
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8 |
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9 |
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10 |
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BACTERIOLOGICAL WATER QUALITY CHART | |||||||||||
Analysis Number |
Date |
Total Coliforms MPN/100 ml |
Escherichia Coli MPN/100 ml |
Analysis Number |
Date |
Total Coliforms MPN/100 ml |
Escherichia Coli MPN/100 ml |
Analysis Number |
Date |
Total Coliforms MPN/100 ml |
Escherichia Coli MPN/100 ml |
1 |
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2 |
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3 |
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4 |
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5 |
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6 |
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7 |
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8 |
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9 |
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10 |
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