Section IX - Annexure

Annexure I

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 ANNEXURE II: FIELD SURVEY FORMATS FOR DATA COLLECTION

Field Survey Format for Data Collection of Buildings/Plots

Date of Survey:

Sheet ID:

Parcel ID:

Road ID*:

Ward No.:

Locality/Colony Name:

Road Name:

Land Use*:

Land Use Details:

Type of Construction#:

Remarks (If Any):

Signature of the Surveyor Signature of Team Leader

Field Survey Format for Data Collection of Water Supply Network

Date of Survey:

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Sheet ID:

Water Supply Network ID:

Road Name:

Locality Name:

Distance from Road (in metre)

Construction Materials#:

PSC ID MS RCC GI

AC CI PVC HDPE Other

Remarks (in Case of any other):

Network Line Type: Distribution Pumping Service Raw

Line Line Line Water
Main

Pipe Diameter (in mm)

Signature of the Surveyor Signature of Team Leader

#Construction Material: PSC- Pre-Stressed Concrete,- DI- ductile Iron ,MS- Mild Steel, RCC –
Reinforced Cement Concrete; GI – Galvanized Iron; CI – Cast Iron; PVC - Polyvinyl chloride (Plastic
Pipe), HDPE- High Density Poly ethylene .

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 Field Survey Format for Data Collection of Drainage Network

Date of Survey:

Sheet ID:

Drainage ID:

Road Name:

Locality Name:

Distance from Road (in metre)

Drainage Construction Type: Box Channel Open Channel

Depth of Drainage: (in metre)

Network Line Type: Main Drainage Service

Line Pumping Line
Line

Signature of the Surveyor Signature of Team Leader

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 Field Survey Format for Data Collection of Sewerage Network

Date of Survey:

Sheet ID:

Sewerage Network ID:

Road Name:

Locality Name:

Construction Material#:
RCC SWG GI AC CI

PVC Other

Remarks (in case of any other)

Network Line Type: Sewerage Sewerage Service

Line Pumping Line Line

Pipe Diameter (in mm)

Signature of the Surveyor Signature of Team Leader

#Construction Material: RCC – Reinforced Cement Concrete; SWG- Stone Ware Glazed , GI –
Galvanized Iron; CI – Cast Iron; PVC Polyvinyl chloride (Plastic Pipe).

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 Field Survey Format for Other Basic Infrastructure

Date of Survey:

Sheet ID:

ID:

Road Name:

Locality Name:

Other Basic Infrastructure*:

Description if any:

Capacity**:

Status Working Not Working

Signature of the Surveyor Signature of Team Leader