Appendix A

BARANGAY REQUEST FOR VERIFICATION AND CERTIFICATION OF ZERO

OPEN DEFECATION (ZOD) STATUS

Date: October 21, 2022

To: The City Health Officer

Municipal/City Verification Team
Municipality/City of Roxas
Province of Capiz

Dear Sir/Madam:
We are glad to inform you that our barangay has achieved Zero Defecation (ZOD) Status as of
October 26, 2022. In this regard we would like to request the Municipal/City Verification Team
to conduct the ZOD Verification exercise and certify our status as a ZOD barangay. Enclosed is
our ZOD Report and community map for your reference.

Name of Barangay: Barangay Inzo Arnaldo Village

Total Number of Households:

Type Of Toilet Number Of Units Number Of Household Served

Individual Toilet 675 675
Shared Toilet (2 to 3 households) 10 25 H.H
Communal Toilet (10 households or 50 N/A N/A
persons)
TOTAL 700 H.H

Thank you very much,

Very Truly yours,

EINSTEIN CHINUMEZI T. OKPORA

Barangay Chairman/Captain
Appendix B: ZOD Report Template

1. Please describe briefly how your community was mobilized to stop defecating in the open.
The community was mobilized to stop defecating in the open by:
1. Strict implementation of Barangay Ordinance (ZOD Ordinance)
2. Adequate advocacy on Zero Open Defecation.

2. Please share any innovations to achieve ZOD status (e.g. mobilizations of community members,
innovations in constructing toilets, innovative designs and use of locally available materials, etc.)
All Households have access to sanitary toilets.

3. Please submit a simple community map which indicates the key boundaries and landmarks of
barangay, households and toilets. This will support the Verification Team to plan their
verification visit.