Drinking Water Quality Data Submission Form

Water Quality Submission Form

Please enter data for drinking water quality tests conducted in Vanuatu If you do not have information for any of the boxes, please just leave it blank

General Information
Sample ID
Sample Site ID
Sample Site Name
Please select location/system/facility you want to register a DWQT action
Please use the location area or the specific system/building selections below to indicate where you are completing a DWQT e.g. for for a specific island, please use the island button OR e.g. for building actions in a community, please select the relevant water system or school
- Province
- Island
- Area Council
- Water System
- School
- Health Centre Facility
Select Water System
Select Health Care Facility
Select School Name
Province
Island
Area Council
Date
Date Format: YYYY dash MM dash DD
Location
Latitude of sample site (Please use Decimal Degrees DD)
Longitude of sample site (Please use Decimal Degrees DD)
Elevation of sample site (m)
Flow rate of source [if applicable] (litres/min)
Location Description
Source Details
Source Type
Specific Source Type
System Type
Physical Parameters
Conductivity (µs/cm)
Turbidity (NTU)
pH
Taste and Odour
Hardness (mg/L)
Chemical Parameters
Fluoride (mg/L)
Arsenic (mg/L)
Copper (mg/L)
Lead (mg/L)
Iron (mg/L)
Free Chlorine (mg/L)
Total Chlorine (mg/L)
Microbiological Parameters
E.Coli Test Method
E.coli (cfu/100ml) [NB: If result is "Too Numerous To Count (TNTC) please enter the number 2001 into the box]
Total Coliforms (cfu/100ml) [NB: If result is "Too Numerous To Count (TNTC) please enter the number 2001 into the box]
Faecal Coliforms (cfu/100ml) [NB: If result is "Too Numerous To Count (TNTC) please enter the number 2001 into the box]
Additional Comments
Comments
Sharing with the Community
Please indicate if the information has been shared with the community or other stakeholders
Information shared?

Water Quality Submission Form

General Information

Location

Source Details

Physical Parameters

Chemical Parameters

Microbiological Parameters

Additional Comments

Sharing with the Community

DoWR NIP-CAP Information System

Vanuatu

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