Application Questionnaire
The Rotary Clubs of Oakville
P.O. Box 20055                                                                 
520 Kerr Street
Oakville, Ontario L6K 3Y7



Water for Humanity  -  Site Selection Questionnaire


By answering the questions below, please describe why you feel this location is a good choice for a  Water for
Humanity “project.


Note:  The following site selection criteria are listed in descending order of importance.  Sites which do not meet the
first  five criteria will not be given further consideration at the present time.   Please provide answers in the space below
each question.



Sustainability Considerations

1.        Does the community have electrical power? If so, what is the voltage and amperage available?





2.        Is the drinking water quality continuously affected by the presence of disease producing organisms such as
bacteria and viruses, or is contamination a result of chemical contamination such as arsenic, lead, mercury, high
salinity, etc.?





3.        What are the estimated total numbers of people who would receive benefit from the system now and over the
next five years, as a result of ongoing local investments in infrastructure to distribute treated water to increasingly
larger numbers of residents in the area?





4.        Does the community currently have individuals or groups who are responsible for the operation of other critical
services and would therefore assume responsibility for operating a new water treatment system?




5.        What capabilities exist within the region for local Rotary member support for the project and how close (hours
driving time) is this support capability from the proposed site:
a.        Management of government interaction (federal, regional and local).
b.        Support for infrastructure construction
c.        Start up support
d.        Ongoing operation support and follow up.







Water Usage

1.        How do residents currently obtain their drinking water?  Is it distributed to them or must they fetch their own from
a central source?




2.        Is there a limited supply of water for the community?




3.        Does water demand vary over the course of the day?  If so, what is the range of demands? (average, maximum,
minimum)




4.        Describe the water quality problem that exists within the community.  Has the water quality ever been tested?  If
so, please provide results.




5.        How many households are there in the community? How many people? How many people will utilize the
proposed water source?  Will this increase if cleaner water becomes available?




6.        What are some of the more common illnesses in the community? How frequent? What age groups are most
affected?




7.         If clean water becomes available, what will this water primarily be used for? (drinking, cooking, toilets, showers,
etc.)




8.        What is the minimum / average and maximum distance from people’s homes to the proposed site?



9.         Does a water distribution system infrastructure currently exist ? (water tower or reservoir and piping system to
homes -  please provide details on sizing, materials of construction and age).  If not , what does exist?


10.         Where / how does the community currently treat / dispose of its wastewater and sewage water?





Physical / Chemical Conditions of Source

1.        What is the source of community drinking water at the present time (shallow dug well <3 m deep), drilled well,
surface water from a lake or river, rainwater)?



2.        Does the water quality change seasonally? If a well, does the output of the well change seasonally?  If a surface
water source, does it run dry seasonally?  What are the seasons? When during the year do they occur?



3.        Please provide a current water analysis.  



4.        Are there any local or near-by surface water sources or point sources for contamination?




5.        What is the temperature of the water? Does this vary?





Additional Considerations

a.        Are there sufficient sanitation facilities for the population?




b.        How many schools are there in the area? What is the student population? What are the class divisions and
classroom sizes?




c.        What council and/or community representation exists at the local government level?