This document contains a rapid water situation assessment for a municipality and village, including information on available water sources and quality, treatment methods, water supply levels throughout the year, seasonal fluctuations, ownership of water sources and facilities, indigenous water requirements, pollution of sources, and remarks or recommendations. Contact information is provided for the assessor and sources of information. Water sources include wells, springs, surface water collectors, and hill reservoirs.

1. CIMIC Field Handbook Annex 21
Annex 21-1 Version 3.0.0
Annex 21 Rapid Water Situation Assessment
Municipality Village MGRS Grid Ref
Agency Name ofassessor Date
Source ofinformation (give as much detail as possible – givea telephone ofsomeone in the village if possible)
SOURCES
WELLS SPRINGS SURFACE WATER COLLECTORS HILL RESERVOIRES
Y / N Y / N Y / N Y / N
LOCATIONS/QUALITY
TREATMENT
SEDIMENTATION FILTRATION CHEMICAL MISCELLANEOUS/COMBINATION
Y / N Y / N Y / N Y / N
WATER SUPPLY
LEVELS
WINTER SPRING SUMMER AUTUMN
……M3 ……M3 ……M3 ……M3
SEASONAL
FLUCTUATIONS
..…M3-..…M3 ..…M3-..…M3 ..…M3-..…M3 ..…M3-..…M3
OWNERSHIP OF
SOURCES/ WATER/
TRANSMISSION
FACILITIES
OWNER OF SOURCE/WATER/TRANSMISSION FACILITY LOCATION/ TEL. NUMBER/ EMAIL
INDIGENOUS WATER
REQUIREMENTS
WINTER SPRING SUMMER AUTUMN
……M3 ……M3 ……M3 ……M3
POLLUTION OF
SOURCES/
WATER SUPPLIES
POLLUTANT TYPE/NAME LOCATION
ACTION TAKEN
REMARKS ANDRECOMMENDATIONS