Site Visit Form · Petco360 M&E

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Site Visit Form

New visit · Draft

Header

Demo

Infra

Employees

PET

LBP

Challenges

Photos

Tab 1 of 8 12%

Visit Date *

Visit Type *

Entity *

Province *

Field Officer

Contact Person at Entity

GPS Coordinates

Demographic Information

Entity Type

Ownership Type

B-BBEE Level

Years in Operation

Infrastructure

Has permanent structure

Access to running water

Electricity connected

Waste separation in place

Security fencing

Ablution facilities

Infrastructure Condition

Employees & Waste Pickers

Total Employees (full-time)

Total Employees (part-time)

Female Employees

Youth Employees (18–35)

Employees with Disabilities

Registered Waste Pickers

PET Collections

PET Bev Bottles (kg)

Thermoform PET (kg)

PET HPC Bottles (kg)

PET Buyer / Offtaker

Price Paid (R/kg)

Liquid Board Packaging

LBP Collected (kg)

LBP Buyer / Offtaker

Price Paid (R/kg)

Separate LBP collection point

Awareness signage visible

Challenges & Support Needed

Primary Challenge

Support Required

Field Officer Notes

Follow-up Required?

Photos

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