ISSUE + SITE SURVEY FORM:

SPREADING AWARENESS AND GIVING SOLUTIONS TO USE THE R.O. PURIFIER WASTAGE
WATER

 SURVEY NO.;

 NAME:

 FAMILY MEMBERS NO/AGE/EDUCATION:

 FAMILY TYPE:

 FAMILY EDUCATION:

 ECONOMIC BACKGROUND:

 LOCATION:

 HOUSE TYPE:

 GARDEN/LAWN/PLANTS IN HOUSE? DESCRIBE

 HOUSE SIZE APPROX ALSO HOW MANY PEOPLE IN SOCIETY:

 WATER SUPPLY IN SOCIETY? FULL TIME /FIXED TIME/BOREWELL (personal

/society)

 HARD WATER/SOFT WATER IN SOCIETY OR AREA?CLICK PICTURES OF TAPS IN

KITCHEN AND BATHROOM

 DO YOU HAVE A SHORTAGE OF WATER ON AND OFF IN YOUR HOME/SOCIETY?

 DO YOU USE R.O. PURIFIER? YES / NO
 WHAT ARE CURRENT USES/SITUATION OF R.O. WASTE WATER?DO YOU STORE IT?

 WHY ARENT YOU USING THIS WATER FOR OTHER

PURPOSES?AWARENESS/KNOWLEDGE/MISCONCEPTIONS?

 HOW MUCH SPACE AVAILABLE FOR WASTE WATER STORAGE?WHERE?

 DO YOU PAY BILLS FOR WATER SUPPLY TO GOVT. AT YOUR HOME/SOCIETY? IF

SOCIETY COMMON WATER BILL PLS FIND WATER AMOUNT USAGE AND ALSO
PER LITRE COSTS OF WATER?

 VEG/NON VEGETARIAN FAMILY?For ex: RO wastage water can be used to

boil eggs

 WERE YOU AWARE OF HOW MUCH WATER IS WASTED DURING R.O.

PROCESS/WHAT ARE ITS USES?

 WHAT ARE OTHER PLACES/ACTIVITY IN HOUSE WHERE YOU TRY TO AVOID WTER
WASTAGE THROUGHOUT DAY? HOW MUCH WATER SAVED APPROXIMATELY IN
THESE ACTIVITIES BY YOUR AWARENESS?for ex:repeatedly telling the maid not
to waste water as she generally might be using ,using low flow /water flow
restrictor on mouth of tap

 HOW MANY LITRES OF WATER CONSUMED APPROX IN A DAY?/HOW MANY

TIMES YOU REFILL YOUR WATER VESSEL/R.O.?

 HOW MANY TIMES R.O. SERVICED?(YEARLY/MONTHLY):

 COSTS PAID FOR R.O. SERVICE(YEARLY/MONTHLY):

 DO YOU HAVE GUESTS/RELATIVES COMING IN TOO OFTEN?

 DO FRIENDS OF YOUR KIDS COME TO STAY OFTEN?
 IN SUMMER TIME ARE THERE GUESTS AT HOUSE/SHORT STAY/LONG STAY?