WATER SAFETY

PLAN
Example text in yellow

Rural water supply system

Including climate considerations

[Name of water supply system]

Version:
[XX]

Last Updated:

1
 [DD/MM/YYYY]

Contents

Overview of the Water Safety Plan Steps .................................................................. 3

1 Water Safety Plan Team (Step 1) ........................................................................ 4
2 Water System Description (Step 2)...................................................................... 6
3 Hazard and Control Measure Identification, Risk Assessment and Prioritization
(Step 3) ................................................................................................................ 8
4 Improvement Plan (Step 4) ................................................................................ 17
5 Monitoring Plans (Step 5) .................................................................................. 20
5.1 Operational monitoring plan..................................................................................... 20
5.2 Verification monitoring plan ..................................................................................... 25
6 Water Safety Plan Documentation, Review and Improvement (Step 6) ............. 27
6.1 Management procedures .......................................................................................... 27
6.2 WSP supporting programmes ................................................................................... 28
6.3 WSP review/revision meetings ................................................................................. 29

Annex 1 Standard Operating Procedure Template ............................................. 30

Annex 2 Emergency Response Plan Template .................................................. 31
Annex 3 WSP Assessment Template ................................................................. 32

Important note:

Please print additional sheets as needed to complete each step.

2
 Overview of the Water Safety Plan Steps

The following figure gives a summary of the steps (or tasks) involved in the WSP process.
This WSP template follows each of these steps in the same order.

3
1 Water Safety Plan Team (Step 1)

Key action: Document the details of the WSP team members and outline their key
role and responsibilities. Consider what additional expertize may be required to support
the integration of climate impacts into your WSP.

The core duties of the WSP Team are as follows:

 Engage with the community and stakeholders to ensure community water

supply/quality needs are reflected in the WSP, and to create support and motivation
for WSP develop and implementation (STEP 1)
 Create a map showing drinking water supply from catchment to consumer and fill in
the system information table (STEP 2); consider the current/predicted climate
impacts on the water supply system
 Identify hazards and assess the effectiveness of existing control measures, and
assess and rank risks to water safety from the catchment to consumer (STEP 3);
consider the impact of current/predicted climate change on the profile of existing
risks, as well as any new risk that may be introduced
 Plan, prioritize and lead improvements to water system components to manage
current risks, as well as predicted risks that may arise from climate change (STEP 4)
 Plan and lead on-going monitoring of water system components including household
practices (STEP 5)
 Document management procedures (including emergency response plans to manage
current/predicted climate events); meet routinely to check that WSP activities are
being carried out as planned and the WSP is working effectively, and to make
updates and changes to the WSP if necessary (STEP 6)
 Plan and lead on-going supporting activities to educate staff, households and the
general community about safe water practices (STEP 6); consider what supporting
programmes may be required to support climate resilient WSP activities.

[Add additional responsibilities as required]

4
WSP Team Table:

Name Job title Organization Role on the WSP Team Contact information

Water & Sanitation Water supply system operation Ph. 01 234 5678
Mr. X Caretaker
Management Team and maintenance email@email.com

Note: Use additional sheets as needed.

5
 2 Water System Description (Step 2)
Key action: Briefly describe in words, and in a drawing, the water system from the catchment/source right through to the
point of use by the consumer. Include relevant climate considerations at each process step.

Catchment/source Treatment Storage/distribution/collection Point of use (household)

Describe the general conditions of the Describe if any treatment (e.g. Describe any centralized water storage, and Make a list of the different ways people treat
catchment (e.g. forested, agricultural), the sedimentation, clarification, filtration, how people collect and transport the water (e.g. boiling, filtration, chlorine tablets) and
source(s) of water (e.g. dug well, borehole, chlorination, UV) of the source water (e.g. piped to house, piped to tap stand, store (e.g. in a household tank, jerry can, open
river), the water users/uses, and the number occurs before consumer distribution/ handpump & carry by hand, water carter, kiosk bucket etc.) drinking-water at the household
of people served. Include current/predicted collection. etc.). Consider how the current/predicted level (if practiced). Consider how the
climate considerations (e.g. rain fall, flooding climate considerations may influence these current/predicted climate considerations may
zones, water quality impacts, drought, practices. influence these practices.
alternative water supplies etc.)
Catchment: Chlorination (1% solution Concrete storage tank No household treatment.
 Human settlements with limited prepared from bleaching  200 kL
sanitation facilities powder).  Built 1975 Household water stored in large open
 Etc.  Closed tank ceramic pots (no lid generally), on
Etc.  Cracked walls. ground level and dedicated to water
Source: storage.
 Surface water (river); dug well Collection by consumers at tap stands
 Etc. (three tap stands in the town). Use of dipping tool varies (e.g. cup,
hand, ladle).
Climate considerations: Consumers collect water in open
 Current impacts include more buckets to bring back to households. During floods, consumers cannot
severe rain fall events access tap stands, so will likely rely on
 Future impacts include shortening With predicted increase in annual flood water or rainwater harvesting (if
of the dry season and increased rainfall, consumer likely to switch to it is in place).
annual rain fall rain water harvesting to save water
 Etc. tariffs. Etc.
Etc.
Use additional space as needed

6
Map of the water supply system: Draw a basic map of the water supply system. Include any activities in the catchment (e.g. agriculture, industry, human
settlements), the source(s) of the water (e.g. well, river, bore), any centralized treatment steps (e.g. filtration, chlorination), any storage or distribution infrastructure (e.g.
tanks, pipelines), any collection points (e.g. tap stands, hand pumps, kiosks), collection practices, household water treatment and storage practices and any other
information that may be relevant to water quality and hazard identification. Include relevant climate considerations for each process step.

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3 Hazard and Control Measure Identification, Risk Assessment and
Prioritization (Step 3)

Key actions: At each step of the water system:

1. Identify the possible dangers to water safety (i.e. hazards/hazardous events) that
may impact water quality and community health
2. Assess the effectiveness of any existing control measures that are in place to
manage these risks, and
3. Rank (prioritize) the significance of each risk accordingly.

Based on the current/predicted climate considerations described in the system description

(Step 2), consider (1) the impact on existing hazards/hazardous events and (2) any new
hazards/hazardous events that may arise from these predictions.

Risk assessment approach (descriptive risk assessment):

The WSP team should consider how likely a hazardous event is to occur and how serious it
might be (given the effectiveness of the existing control measures if present), and assign a
risk level.

Definition of risk level:

8
Note: Use additional sheets as needed.

1. Hazardous event 2. Hazard 3. Existing control measures 4. Risk assessment 5. Additional control measures
What can go wrong? If this does go wrong, what What existing control How important is this event Are additional control
hazard(s) might be measures (i.e. barriers to to water safety (i.e. how measures needed?
List what hazardous events could introduced into the water? contamination) are in place to often is it likely to happen
happen that might introduce prevent this (if any)? and what are the If yes, please state what
M = Microorganisms
hazards to your system and may consequences if it does additional control measure(s)
C = Chemical
make your drinking-water unsafe. P = Physical If present, are the control happen)? are needed and include in
Q = Quantity measures working Very important: requires urgent Section 4.
Use the formula: X happens to the effectively? attention and action
Important: requires attention and
water supply because of Y
action may be taken
Less important: no action required at
this time.
Catchment/source
Faecal contamination of the Microbial None Very important Yes.
source water due to flooding
of the well Likelihood: Very likely 1. Build flood defense
due to shallow well and wall around existing
location in low lying area wells
and climate prediction 2. Drill future
for increased annual alternative deep well
rainfall. outside of the flood
Consequence: Faecal zone (consider new
contamination can result requirement for
in widespread public fluoride removal
health impacts. from new well)

9
 1. Hazardous event 2. Hazard 3. Existing control measures 4. Risk assessment 5. Additional control measures
What can go wrong? If this does go wrong, what What existing control How important is this event Are additional control
hazard(s) might be measures (i.e. barriers to to water safety (i.e. how measures needed?
List what hazardous events could introduced into the water? contamination) are in place to often is it likely to happen
happen that might introduce prevent this (if any)? and what are the If yes, please state what
M = Microorganisms
hazards to your system and may consequences if it does additional control measure(s)
C = Chemical
make your drinking-water unsafe. P = Physical If present, are the control happen)? are needed and include in
Q = Quantity measures working Very important: requires urgent Section 4.
Use the formula: X happens to the effectively? attention and action
Important: requires attention and
water supply because of Y
action may be taken
Less important: no action required at
this time.
Catchment/source (continued)

10
 1. Hazardous event 2. Hazard 3. Existing control measures 4. Risk assessment 5. Additional control measures
What can go wrong? If this does go wrong, what What existing control How important is this event Are additional control
hazard(s) might be measures (i.e. barriers to to water safety (i.e. how measures needed?
List what hazardous events could introduced into the water? contamination) are in place to often is it likely to happen
happen that might introduce prevent this (if any)? and what are the If yes, please state what
M = Microorganisms
hazards to your system and may consequences if it does additional control measure(s)
C = Chemical
make your drinking-water unsafe. P = Physical If present, are the control happen)? are needed and include in
Q = Quantity measures working Very important: requires urgent Section 4.
Use the formula: X happens to the effectively? attention and action
Important: requires attention and
water supply because of Y
action may be taken
Less important: no action required at
this time.
Treatment (if any)

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 1. Hazardous event 2. Hazard 3. Existing control measures 4. Risk assessment 5. Additional control measures
What can go wrong? If this does go wrong, what What existing control How important is this event Are additional control
hazard(s) might be measures (i.e. barriers to to water safety (i.e. how measures needed?
List what hazardous events could introduced into the water? contamination) are in place to often is it likely to happen
happen that might introduce prevent this (if any)? and what are the If yes, please state what
M = Microorganisms
hazards to your system and may consequences if it does additional control measure(s)
C = Chemical
make your drinking-water unsafe. P = Physical If present, are the control happen)? are needed and include in
Q = Quantity measures working Very important: requires urgent Section 4.
Use the formula: X happens to the effectively? attention and action
Important: requires attention and
water supply because of Y
action may be taken
Less important: no action required at
this time.
Treatment (if any; continued)

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 1. Hazardous event 2. Hazard 3. Existing control measures 4. Risk assessment 5. Additional control measures
What can go wrong? If this does go wrong, what What existing control How important is this event Are additional control
hazard(s) might be measures (i.e. barriers to to water safety (i.e. how measures needed?
List what hazardous events could introduced into the water? contamination) are in place to often is it likely to happen
happen that might introduce prevent this (if any)? and what are the If yes, please state what
M = Microorganisms
hazards to your system and may consequences if it does additional control measure(s)
C = Chemical
make your drinking-water unsafe. P = Physical If present, are the control happen)? are needed and include in
Q = Quantity measures working Very important: requires urgent Section 4.
Use the formula: X happens to the effectively? attention and action
Important: requires attention and
water supply because of Y
action may be taken
Less important: no action required at
this time.
Storage/distribution/collection

13
 1. Hazardous event 2. Hazard 3. Existing control measures 4. Risk assessment 5. Additional control measures
What can go wrong? If this does go wrong, what What existing control How important is this event Are additional control
hazard(s) might be measures (i.e. barriers to to water safety (i.e. how measures needed?
List what hazardous events could introduced into the water? contamination) are in place to often is it likely to happen
happen that might introduce prevent this (if any)? and what are the If yes, please state what
M = Microorganisms
hazards to your system and may consequences if it does additional control measure(s)
C = Chemical
make your drinking-water unsafe. P = Physical If present, are the control happen)? are needed and include in
Q = Quantity measures working Very important: requires urgent Section 4.
Use the formula: X happens to the effectively? attention and action
Important: requires attention and
water supply because of Y
action may be taken
Less important: no action required at
this time.
Storage/distribution/collection (continued)

14
 1. Hazardous event 2. Hazard 3. Existing control measures 4. Risk assessment 5. Additional control measures
What can go wrong? If this does go wrong, what What existing control How important is this event Are additional control
hazard(s) might be measures (i.e. barriers to to water safety (i.e. how measures needed?
List what hazardous events could introduced into the water? contamination) are in place to often is it likely to happen
happen that might introduce prevent this (if any)? and what are the If yes, please state what
M = Microorganisms
hazards to your system and may consequences if it does additional control measure(s)
C = Chemical
make your drinking-water unsafe. P = Physical If present, are the control happen)? are needed and include in
Q = Quantity measures working Very important: requires urgent Section 4.
Use the formula: X happens to the effectively? attention and action
Important: requires attention and
water supply because of Y
action may be taken
Less important: no action required at
this time.
Point of use (household treatment, storage and handling)

15
 1. Hazardous event 2. Hazard 3. Existing control measures 4. Risk assessment 5. Additional control measures
What can go wrong? If this does go wrong, what What existing control How important is this event Are additional control
hazard(s) might be measures (i.e. barriers to to water safety (i.e. how measures needed?
List what hazardous events could introduced into the water? contamination) are in place to often is it likely to happen
happen that might introduce prevent this (if any)? and what are the If yes, please state what
M = Microorganisms
hazards to your system and may consequences if it does additional control measure(s)
C = Chemical
make your drinking-water unsafe. P = Physical If present, are the control happen)? are needed and include in
Q = Quantity measures working Very important: requires urgent Section 4.
Use the formula: X happens to the effectively? attention and action
Important: requires attention and
water supply because of Y
action may be taken
Less important: no action required at
this time.
Point of use (household treatment, storage and handling; continued)

16
4 Improvement Plan (Step 4)
Key action: Document the details of the additional control measures needed that were identified in Step 3 (Column 5).

Who is
What improvement is What is the priority How much Where will the
responsible for Planned Planned
needed? level? is it budget come Status?
coordinating the start finish
(From Column 5 of the (High/medium/low) completion of this estimated from? date? date?
table in Section 3) to cost?
improvement?
1 Build flood defense High Community water 2000 USD Regional June 2017 August Underway
wall around existing supply authority infrastructure 2017
wells 1 and 2 budget

17
 Who is
What improvement is What is the priority How much Where will the
responsible for Planned Planned
needed? level? is it budget come Status?
coordinating the start finish
(From Column 5 of the (High/medium/low) completion of this estimated from? date? date?
table in Section 3) to cost?
improvement?
4

18
 Who is
What improvement is What is the priority How much Where will the
responsible for Planned Planned
needed? level? is it budget come Status?
coordinating the start finish
(From Column 5 of the (High/medium/low) completion of this estimated from? date? date?
table in Section 3) to cost?
improvement?
8

10

11

Note: Use additional sheets as needed.

19
5 Monitoring Plans (Step 5)
Key actions: Document the details of the plan for (1) monitoring of the existing control measures identified in Step 3 (Column 3; i.e.
operational monitoring plan) and (2) verifying that the WSP is working effectively (i.e. verification monitoring plan).

5.1 Operational monitoring plan (use additional sheets as needed)

Control measure How will this existing control measure be When is the control What needs to be done if the
(from Column 3 in monitored/inspected? measure considered to be control measure is not working?
Step 3) not working?
Drainage ditch to What needs to Condition of the drainage ditch When the diversion ditch  Notify WSP team leader
divert pig farm be monitored? is clogged and/or  Stop harvesting raw water
flow from entering How will it be Visual inspection overflowing. from the river
the river monitored? Remove material from
When will it Dry season – monthly drainage ditch as soon as
be monitored? Wet season – weekly possible.
Where will it At the pig farm perimeter
be monitored?
Who will Caretaker
monitor it?
What needs to
be monitored?
How will it be
monitored?
When will it
be monitored?
Where will it
be monitored?
Who will
monitor it?

20
 Control measure How will this existing control measure be When is the control What needs to be done if the
(from Column 3 in monitored/inspected? measure considered to be control measure is not working?
Step 3) not working?
What needs to
be monitored?
How will it be
monitored?
When will it
be monitored?
Where will it
be monitored?
Who will
monitor it?
What needs to
be monitored?
How will it be
monitored?
When will it
be monitored?
Where will it
be monitored?
Who will
monitor it?

21
 Control measure How will this existing control measure be When is the control What needs to be done if the
(from Column 3 in monitored/inspected? measure considered to be control measure is not working?
Step 3) not working?
What needs to
be monitored?
How will it be
monitored?
When will it
be monitored?
Where will it
be monitored?
Who will
monitor it?
What needs to
be monitored?
How will it be
monitored?
When will it
be monitored?
Where will it
be monitored?
Who will
monitor it?

Control measure How will this existing control measure be When is the control What needs to be done if the
(from Column 3 in monitored/inspected? measure considered to be control measure is not working?
Step 3) not working?
What needs to

22
 Control measure How will this existing control measure be When is the control What needs to be done if the
(from Column 3 in monitored/inspected? measure considered to be control measure is not working?
Step 3) not working?
be monitored?
How will it be
monitored?
When will it
be monitored?
Where will it
be monitored?
Who will
monitor it?
What needs to
be monitored?
How will it be
monitored?
When will it
be monitored?
Where will it
be monitored?
Who will
monitor it?

Control measure How will this existing control measure be When is the control What needs to be done if the
(from Column 3 in monitored/inspected? measure considered to be control measure is not working?
Step 3) not working?
What needs to
be monitored?

23
 Control measure How will this existing control measure be When is the control What needs to be done if the
(from Column 3 in monitored/inspected? measure considered to be control measure is not working?
Step 3) not working?
How will it be
monitored?
When will it
be monitored?
Where will it
be monitored?
Who will
monitor it?
What needs to
be monitored?
How will it be
monitored?
When will it
be monitored?
Where will it
be monitored?
Who will
monitor it?

Control measure How will this existing control measure be When is the control What needs to be done if the
(from Column 3 in monitored/inspected? measure considered to be control measure is not working?
Step 3) not working?
What needs to
be monitored?

24
 Control measure How will this existing control measure be When is the control What needs to be done if the
(from Column 3 in monitored/inspected? measure considered to be control measure is not working?
Step 3) not working?
How will it be
monitored?
When will it
be monitored?
Where will it
be monitored?
Who will
monitor it?
What needs to
be monitored?
How will it be
monitored?
When will it
be monitored?
Where will it
be monitored?
Who will
monitor it?

5.2 Verification monitoring plan (use additional rows as needed)

25
What needs to be What locations will How often? And Who will do the What is the target WSP team
checked? be checked? how many samples checking? outcome? member to report
will be taken? the outcome to?
Water quality testing (compliance monitoring) (e.g. E. coli, faecal coliforms, turbidity)
E. coli Household storage Monthly Environmental Health 0 E. coli/100 mL WSP Team Leader
container (1 Assistant
household per
month)
Sanitary inspection (e.g. at source, collection point, household etc.)
Sanitary condition Storage tank 1 survey per month Environmental Health “Low” risk score WSP Team Leader
Assistant
Tap stand 1 survey per month Environmental Health “Low” risk score WSP Team Leader
Assistant
Household 3 households per Environmental Health “Low” risk score WSP Team Leader
collection/storage month Assistant
containers
WSP implementation (e.g. WSP assessment [see Annex 3])
Implementation of Whole WSP (source 1 audit per year District Audit pass WSP Team Leader
WSP to household) Environmental Health
Officer

Consumer satisfaction (e.g. satisfaction survey)

Level of consumer Households Performed once per District “High” level of WSP Team Leader
satisfaction year; covering 25 Environmental Health customer satisfaction
households Officer received from 80% of
households

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6 Water Safety Plan Documentation, Review and Improvement
(Step 6)
Key actions:
(1) Document key management procedures and emergency response plans (including
climate related emergencies).
(2) Plan supporting programme for on-going education & awareness raising for the
WSP team & community (including programmes that support climate resilient WSP
activities).
(3) Review the WSP (both routinely and following incidents/emergencies) to check
that it is up-to-date and accurate; revise the WSP as necessary.

6.1 Management procedures

Templates for Standard Operating Procedures (Annex 1) and Emergency Response Plans
(Annex 2) may be found in the annexes. Complete these as required and store in a folder
alongside the WSP, and in the field as required. Consider the type of emergency situations
that may arise from current/predicted climate impacts and develop emergency response
plans to manage these events.

27
6.2 WSP supporting programmes

Key action: Document the details of a supporting programme for on-going education & awareness raising for the WSP team & community.
Consider the type of supporting programmes that may be needed to support the management of current/predicted climate related risks
that have been identified.

How often will the Name of the person in

What specific supporting activity will be carried out?
activity be carried out? charge of this activity?

Water safety awareness during an emergency, such as a flood Six monthly Ms. Y

Note: Use additional sheets as needed.

28
6.3 WSP review/revision meetings
Key action: Document any key information from WSP review meetings

Reason for meeting

Date of WSP Participants Key outcomes/ Person Date
(e.g. routine or post Topics discussed
review meeting present actions responsible completed
incident/emergency)

1 Oct. 2016 Routine monthly Mr. X Status of District Technical Mr. X Open
meeting. Ms. Y improvement Team to be
Ms. Z plan updated on
implementation. improvement plan
implementation

Note: Use additional sheets as needed.

29
Annex 1 Standard Operating Procedure Template

To document step-by-step instructions for carrying out routine tasks in your water supply
system, use the following template. (Note: use additional sheets as needed.)

Task to be Frequency Instructions Person

completed responsible

Inspection of the Dry  Start inspection at the east end of the Caretaker
pig farm season – pig farm
diversion ditch monthly  Walk along the drainage ditch from
east to west until you reach the west
Wet end of the farm perimeter
season –  Visually check the diversion ditch for
weekly obvious signs of clogging (e.g.
branches, sediments etc.) or damage to
the diversion ditch banks.

If the diversion ditch appears to be

clogged/obstructed/damaged/overflowing,
report to the WSP team leader
immediately.

30
Annex 2 Emergency Response Plan Template

To document your actions in response to an emergency situation, use the following

template (Note: use additional sheets as needed.)

Possible emergency Detection of faecal contamination (E. coli) in the treated water
situation(s) supply following flood.

Steps to be taken to Issue boil water advisory

protect the water
supply/public health

Person(s) to be WSP team leader (Ph. 12345678)

notified (internal and Public health officer (Ph. 12345679)
external) and method Community leader (Ph. 12345670)
of notification District health officer (Ph. 12345677)

Method of notifying Public announcement.

the community Sign at tap stands.
Door to door visits.

Source of alternative None available.

water supply Community to be advised to boil the water before consumption
until further notice.

31
Annex 3 WSP Assessment Template

To carry out an assessment of the WSP, use the following template.

General information
District:

Water supply name:

Date of assessment:

Assessor(s):

Water supply type:

(e.g. point source [well,
spring etc.], piped water
supply, any treatment
etc.)
Primary contact for the
water supply system
(name, contact details)
Overall WSP assessment
summary:
(to be completed at the
end)

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WSP Assessment
Comments/Areas for improvement
Assessment
# Question (include reasons for your assessment mark and list any
(Good/Average/Poor)
possible ways in which this area can be improved)
1 Is the WSP team list current?

2 Is the system description accurate and up-to-

date?

3 Is the hazard identification, control measure

assessment and risk assessment understood and
thorough?

4 Is the improvement plan up-to-date and being

implemented?

5 Is operational monitoring being carried out as

per the plan?

6 Is verification monitoring being carried out as

per the plan?

33
WSP Assessment
Comments/Areas for improvement
Assessment
# Question (include reasons for your assessment mark and list any
(Good/Average/Poor)
possible ways in which this area can be improved)
7 If in use, are standard operating procedures and
emergency response plans appropriate and
being followed?

8 Is the awareness raising plan appropriate for the

needs of the staff/community and being
implemented?

9 Are the WSP team meeting routinely and the

WSP being revised as appropriate?

10 Are climate considerations integrated

appropriately into the relevant steps?

-------------------------------------- -------------------------------------------------------------
Date Signature of assessor(s)

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