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Annex 5

Sample Social Consultation Forms

Punjab Rural Water Supply and Sanitation Project

State Program Management Cell

Social Consultation Minutes

Date / 23-09-09
Scheme / Talwara
Block / Bassi Pathana
District / Fatehgarh Sahib
Name of Sarpanch / S. Pritam Singh
Key Members of GPWSC / Sarup Singh,Sikander Singh,Dalip Singh
GPWSC set up (date) / 04/03/06
Last meeting held (date) / 08/09/09
Whether Register of Meetings available and properly signed / Yes
Non-GP members of GPWSC, how selected / 5 no.s, in the meeting of gram sabha
Name of J.E.(DPMC and DWSS) / Jasvir Singh, Sanjeev Kumar
Name of S.D.E. (DPMC and DWSS) / Sh. Mulkh Raj, Sh. Parmod Chand
Name of HRD Specialist attending / Sh. Pawan Kumar
Name of IEC Specialist attending / Smt. Sangeeta Tripathi
Total households in village / 188
No of Connections / 138
Percentage of SC populations / 56%
No of SC households connected / 75
Total Pipeline length / 110mm-39mtrs, 90mm-67mtrs,75mm-3771mtrs
Depth of Tubewell / 150mtrs
Commissioning (Date) / 09/08/08
Whether Completion Certificate Received, if yes, date thereof / No
Whether any outstanding liabilities , if yes, amount and package referred / Yes, 3rd & final Installment
Expenditure (Capital) / 25.68 lacs
O&M Expenses and details / Rs.3000 pump operator, Rs.4500 electricity charges, Rs.1000 Misc charges
Hrs of Operation / 4 ½ hours per day
Whether 100% collected for Beneficiary contribution / Yes
Monthly tariff for water charges / Rs.75/-
Whether connection charges recovered, if yes, amount thereof and percentage / Yes, Rs.10350/-, 73%
Whether GPWSC maintains two separate bank accounts for beneficiary contribution and for O&M; provide bank account numbers and name of bank / Yes Beneficiary contribution______O&M State Bank of Patiala-6500700 3829
Opinion of Sarpanch – whether HRD and IEC specialists have succeeded in providing adequate inputs and awareness to the village population / Yes
Opinion of HRD specialist/IEC specialist – difficulties experienced in providing inputs to villagers on water quality, and need to take connections, etc. / No there is no problem
Opinion of all parties – rough time within which unconnected households will take connections – approx percentage who are likely to take connections and approx timeline for same / 10% within next 2 months
Accounting and Book-keeping – whether necessary records are being kept- Cash Book, Vouchers, etc. / Yes
Amount outstanding as Advance against the GPWSC as of date, if any and reason therefor / No
Approx amount of surplus from O&M collection per month / 1500/-
Whether GPWSC has taken any decision for use of the surplus funds in the future; if decision not yet formalized then likelihood of the same in the near future / Yes
Opinion of Sarpanch on status of Sewerage in the village and what needs to be done / The village gram panchayat & community members want sewerage system in their village.
Opinion of HRD and IEC specialists on health hazards in village because of lack of sanitation and sewerage / Yes there is an urgent need to tackle the poor condition of sanitation to prevent disease outbreak in this village
Whether GP will, if requested, provide land for Sanitation treatment / Yes
Whether there is any inventory of spare parts for repairs and if so approx value thereof; Please also state how the inventory was paid for. / No

Representatives of DPMC attending:

1.  Name Sh.Mulkh Raj

Designation S.D.E

2.  Name Sh.Pawan Kumar

Designation H.R.D Specialist

3.  Name Smt.Sangeeta Tripathi

Designation I.E.C Specialist

Punjab Rural Water Supply and Sanitation Project

State Program Management Cell

Social Consultation Minutes

Date / 26/09/09
Scheme / Water Supply Scheme Ladhran
Block / Nakodar
District / Jalandhar
Name of Sarpanch / Sh. Lachhman Dass
Key Members of GPWSC / Sh. Lachhman Dass, Chairman, Amrik Singh, Secretary
GPWSC set up (date) / 10/09/06
Last meeting held (date) / 06/09/09
Whether Register of Meetings available and properly signed / Yes
Non-GP members of GPWSC, how selected / In Gram Sabha Meeting as per criteria given by WB
Name of J.E.(DPMC and DWSS) / Surinder Pal ( DPMC), T.S. Walia (DWSS)
Name of S.D.E. (DPMC and DWSS) / R.P. Singh (DPMC) P.L.Saini (DWSS)
Name of HRD Specialist attending / Gurditta Mal
Name of IEC Specialist attending / Viney Malhan
Total households in village / 210
No of Connections / 200
Percentage of SC populations / 53%
No of SC households connected / 113
Total Pipeline length / 4500 Meter
Depth of Tube well / 200mm i/d 125m deep
Commissioning (Date) / 03/08
Whether Completion Certificate Received, if yes, date thereof / Yes ( 10-04-08)
Whether any outstanding liabilities , if yes, amount and package referred / Rs. 116437/-(As per completion report)
Expenditure (Capital) / 30.34 lac
O&M Expenses and details / Rs. 11500/- ( Electricity Bill- , Salary of operator- , General maintenance- ,
Hrs of Operation / 1.5 Hrs Morning, 1 Hrs Noon, 1.5 Hrs Evening
Whether 100% collected for Beneficiary contribution / Yes ( 3.45 lac)
Monthly tariff for water charges / Rs. 70/-
Whether connection charges recovered, if yes, amount thereof and percentage / Yes, (Rs. 71750/-), 100%
Whether GPWSC maintains two separate bank accounts for beneficiary contribution and for O&M; provide bank account numbers and name of bank / 1)  PNB Mehatpur, Nakodar, Account no. 11101
2)  Canara Bank, Nakodar, Account No. 42698
Opinion of Sarpanch – whether HRD and IEC specialists have succeeded in providing adequate inputs and awareness to the village population / Yes, IEC & HRD activities have succeeded in providing knowledge and building their capacity.
Opinion of HRD specialist/IEC specialist – difficulties experienced in providing inputs to villagers on water quality, and need to take connections, etc. / Some people were convinced after water quality testing demonstration of their hand pumps
Opinion of all parties – rough time within which unconnected households will take connections – approx percentage who are likely to take connections and approx timeline for same / 200 connections are there out of 210 households. GPWSC members told that they will motivate remaining households to take connections within a month.
Accounting and Book-keeping – whether necessary records are being kept- Cash Book, Vouchers, etc. / Yes
Amount outstanding as Advance against the GPWSC as of date, if any and reason therefore / Nil
Approx amount of surplus from O&M collection per month / Rs. 2500/- per month
Whether GPWSC has taken any decision for use of the surplus funds in the future; if decision not yet formalized then likelihood of the same in the near future / The funds will be used for O & M of scheme.
Opinion of Sarpanch on status of Sewerage in the village and what needs to be done / 50% houses have toilets. Sewerage system is required
Opinion of HRD and IEC specialists on health hazards in village because of lack of sanitation and sewerage / In rainy season water flow from septic tanks mixes with rain water and gathers in the two streets of village.
Whether GP will, if requested, provide land for Sanitation treatment / GP will provide land for sanitation treatment
Whether there is any inventory of spare parts for repairs and if so approx value thereof; Please also state how the inventory was paid for. / Nil

Representatives of DPMC attending:

4.  Name : G.S. Heer

Designation : Executive Engineer

5.  Name : R.P. Singh

Designation : SDE

6.  Name : Viney Malhan

Designation : IEC Specialist


Punjab Rural Water Supply and Sanitation Project

State Program Management Cell

Social Consultation Minutes

Date / 24/09/09
Scheme / Water Supply Scheme Raipur
Block / Jalandhar East
District / Jalandhar
Name of Sarpanch / Sh. Desraj
Key Members of GPWSC / Sh. Desraj, Chairman, Nirmal Singh, Secretary
GPWSC set up (date) / 10/04/08
Last meeting held (date) / 08/09/09
Whether Register of Meetings available and properly signed / Yes
Non-GP members of GPWSC, how selected / In Gram Sabha Meeting as per criteria given by WB
Name of J.E.(DPMC and DWSS) / Paramvir Singh ( DPMC), R.K. Sharut (DWSS)
Name of S.D.E. (DPMC and DWSS) / R.P. Singh (DPMC) P.L.Saini (DWSS)
Name of HRD Specialist attending / Gurditta Mal, HRD Specialist (DPMC)
Name of IEC Specialist attending / Viney Malhan, IEC Specialist
Total households in village / 315
No of Connections / 308
Percentage of SC populations / 50.4%
No of SC households connected / 157
Total Pipeline length / 2362 Meter
Depth of Tube well / 200mm i/d 125m deep
Commissioning (Date) / 09/08
Whether Completion Certificate Received, if yes, date thereof / Yes ( 17-10-08)
Whether any outstanding liabilities , if yes, amount and package referred / Rs. 437296/-(As per completion report)
Expenditure (Capital) / Rs. 27 lac
O&M Expenses and details / Rs. 9000/-( Electricity bill, salary, general maintenance)
Hrs of Operation / 4 hrs ( 2 hrs morning, 2hrs evening)
Whether 100% collected for Beneficiary contribution / Yes ( 3.00 lac)
Monthly tariff for water charges / Rs. 60/-
Whether connection charges recovered, if yes, amount thereof and percentage / Yes ( Rs. 81750/-) 100%
Whether GPWSC maintains two separate bank accounts for beneficiary contribution and for O&M; provide bank account numbers and name of bank / 1)  The jal. Co. op. Bank Branch Raipur Pharala, Account no. 53
2)  Cooperative Bank Raipur,
Account No:- SBLBI A/C no. 64
Opinion of Sarpanch – whether HRD and IEC specialists have succeeded in providing adequate inputs and awareness to the village population / HRD & IEC activities have succeeded in providing adequate inputs and knowledge to villagers. Regular camps, meetings & IPC being done
Opinion of HRD specialist/IEC specialist – difficulties experienced in providing inputs to villagers on water quality, and need to take connections, etc. / Some villagers who have submersible pumps had to convinced by the department by conducted water quality testing and they agreed to take connections after that.
Opinion of all parties – rough time within which unconnected households will take connections – approx percentage who are likely to take connections and approx timeline for same / 100% connections have been achieved. Out of 315 households 308 have taken water connections and remain 7 houses are closed.
Accounting and Book-keeping – whether necessary records are being kept- Cash Book, Vouchers, etc. / Yes
Amount outstanding as Advance against the GPWSC as of date, if any and reason therefore / Nil
Approx amount of surplus from O&M collection per month / Rs. 5480/- per month
Whether GPWSC has taken any decision for use of the surplus funds in the future; if decision not yet formalized then likelihood of the same in the near future / The funds will be used for O & M of scheme
Opinion of Sarpanch on status of Sewerage in the village and what needs to be done / 80% houses have toilets but no sewerage system. Sewerage system is required.
Opinion of HRD and IEC specialists on health hazards in village because of lack of sanitation and sewerage / Water flow from toilets can cause diseases. There are two streets where water from septic tanks gathers.
Whether GP will, if requested, provide land for Sanitation treatment / Yes
Whether there is any inventory of spare parts for repairs and if so approx value thereof; Please also state how the inventory was paid for. / Nil

Representatives of DPMC attending:

1  Name : G.S. Heer

Designation : Executive Engineer

2  Name : Gurditta Mal

Designation : HRD Specialist

3  Name : Viney Malhan

Designation : IEC Specialist

Punjab Rural Water Supply and Sanitation Project

State Program Management Cell

Social Consultation Minutes

Date / 29-09-09
Scheme / Shahpur
Block / Amloh
District / Fatehgarh Sahib
Name of Sarpanch / Sh. Kashmira Singh
Key Members of GPWSC / Sh. Sukhwinder Singh, Sh. Jagir Singh, Sh. Sarup Singh
GPWSC set up (date) / 06-03-06
Last meeting held (date) / 25-09-09
Whether Register of Meetings available and properly signed / Yes
Non-GP members of GPWSC, how selected / 5 no.s, in the meeting of gram sabha
Name of J.E.(DPMC and DWSS) / Sh. Jasvir Singh, Sh. Parveen Kumar
Name of S.D.E. (DPMC and DWSS) / Sh. Mulkh Raj, Sh. Amritpal Singh Julka
Name of HRD Specialist attending / Sh. Pawan Kumar
Name of IEC Specialist attending / Smt. Sangeeta Tripathi
Total households in village / 193
No of Connections / 152
Percentage of SC populations / 55%
No of SC households connected / 112
Total Pipeline length / 110mm-296mtrs.63mm-3278mtrs
Depth of Tubewell / 152 mtrs
Commissioning (Date) / 31-01-09
Whether Completion Certificate Received, if yes, date thereof / No
Whether any outstanding liabilities , if yes, amount and package referred / Yes, 3rd & final installment
Expenditure (Capital) / 27.74 Lacs
O&M Expenses and details / Rs. 35,00 Pump Operator, Rs. 45,00 Electricity charges, 1,000 Misc charges
Hrs of Operation / 4 Hours per day
Whether 100% collected for Beneficiary contribution / Yes
Monthly tariff for water charges / Rs. 75/-
Whether connection charges recovered, if yes, amount thereof and percentage / Yes, Rs. 11400/- & 78%
Whether GPWSC maintains two separate bank accounts for beneficiary contribution and for O&M; provide bank account numbers and name of bank / Yes
Beneficiary contribution ______
O&M ______
Opinion of Sarpanch – whether HRD and IEC specialists have succeeded in providing adequate inputs and awareness to the village population / Yes
Opinion of HRD specialist/IEC specialist – difficulties experienced in providing inputs to villagers on water quality, and need to take connections, etc. / No there is no problem
Opinion of all parties – rough time within which unconnected households will take connections – approx percentage who are likely to take connections and approx timeline for same / 5% within next 2 Months
Accounting and Book-keeping – whether necessary records are being kept- Cash Book, Vouchers, etc. / Yes
Amount outstanding as Advance against the GPWSC as of date, if any and reason therefor / No
Approx amount of surplus from O&M collection per month / Rs. 2,000/-
Whether GPWSC has taken any decision for use of the surplus funds in the future; if decision not yet formalized then likelihood of the same in the near future / Yes
Opinion of Sarpanch on status of Sewerage in the village and what needs to be done / The village gram panchayat & community members want sewerage system in their village.
Opinion of HRD and IEC specialists on health hazards in village because of lack of sanitation and sewerage / Yes there is an urgent need to tackle the poor condition of sanitation to prevent disease outbreak in this village.
Whether GP will, if requested, provide land for Sanitation treatment / Yes
Whether there is any inventory of spare parts for repairs and if so approx value thereof; Please also state how the inventory was paid for. / No

Representatives of DPMC attending: