Prd by - MY SIOLIM: The Environment and Heritage Club for V.P Siolim-Marna  
Gregory D'Souza [Convenor]

SURVEY FOR SINGLE HOUSE DWELLING

Name of Ward *
Name *
Hno *
Contact *
No. of Family members *
Total no. of Male (In family) *
Total no. of female(In family) *
children (Age 0-6)(In family) *
Children (Age 13-40)(In family) *
Dry waste{quantity per day} *
Wet Waste(quantity per day) *
Medical waste (quantity ] *
E- waste/ bulb/ battery(quantity) *
Diapers/sanitary napkins (quantity) *
Glass bottles (quantity] monthly *
Feedback and suggestions to improve garbage collection to serve you'll better
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