INFRASTRUCTURE SURVEY QUESTIONNAIRE

Survey No.:- ....... Date.................................

Interviewer Name:- ........................................................

Interviewer Signature:- .........................................................

Interview Date:- .........................................................

Interview Time:- .........................................................

Study area: Amravati

Type of Dwelling : Residential/Commercial/Mixed/Institutional

Height of the dwelling unit .......

PHYSICAL INFRASTRUCTURE

Q1. What is the main source of water?

Municipal CorporationTankerBorewell

If Municipal Corporation, how how ofter?

DailyIn 2 daysMore than 2 days

If Daily, how many hours?

23More than 3Other

Q2. Do you have any problems related to water supply?

YES

NO

If YES, what are your problems related to water supply?

Not CleanExpensiveDifficult to accessLow qualityWater Cuts

If Water Cuts, How fequent?

DailyIn 2 daysMore than 2 days

If Daily, how many hours?

23More than 3Other

Q3. What type of sanitation facility do you have??

WC with flushWC without flushPublic WC

Q4. What is the type of waste water system in your house?

Common sewerage systemSeptic tank by municipalitySelf owned septic tankDirectly discharge to river

Q5. How are solid waste disposed?

Collection by MunicipalityLandfillDisposal in riverBurningNo proper Solid waste disposal

Q6. Do you have electricity in your house

YESNO

If YES, Do you experience a any problems with electricity supply?

Electricity CutsLow VoltageChanging Voltage

If Electricity Cuts, how often

DailyWeeklyMonthly

If Daily, how many hours

2 hrs3 hrsMore than 3 hrs

SOCIAL INFRASTRUCTURE

Q1. Are there any schools and colleges in the study area?

YESNO

If YES, how many…………?

Q2. Are you satisfied with these education facilities?

YESNO

If No,

Do you have any problems/issues related to the educational facilities?

Problem in teacher pupil ratioSchools not as per standards

Q3. Are their any healthcase centres/dispensary in the study area?

YESNO

If YES, how many are there………..?

Q4. Is there any police station in Amravati?

YESNO

If, YES, how may…………..?