This document discusses water and wastewater treatment requirements and systems for hospitals. It provides details on typical daily water requirements for hospitals based on number of beds, including fresh water, recycled water, and treated water needs for various contact and non-contact purposes. It also presents a case study of water requirements and systems for a 70 bed hospital in Tambaram. Cost analyses are given for capital and recurring costs. Water usage and a typical wastewater treatment system layout are depicted. Concerns and solutions regarding odor, operations and maintenance, contamination prevention, and hygiene are addressed.

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2. Water Requirement in Hospitals per 200 Beds 5,000 lts per day 25,000 lts per day 10,000 lts per day De -Mineralized Water Fresh Water Recycle Water NonContactPurpose Contact Purpose Laboratories Canteen Purified Water Glass ware, Reagent Preparation, Diagnostic test Food Preparation, Utensils Washing Floor Wash, Landscaping, Flushing Bathing & Cleaning, Linen & Laundry cleaning Operation theater, Dialysis Unit

3. Water Requirement in Deepam Hospitals, Tambaram. (70 Beds - fully Occupied 7/24) Bore Well/Private Sources (50,000 lts) 40,000 lts per day 20,000 lts per day 10,000 lts per day 30,000 lts per day Treated Water (DM,RO,UV) Fresh Water Recycle Water NonContactPurpose Contact Purpose Laboratories Canteen Purified Water Glass ware, Reagent Preparation, Diagnostic test Drinking, Food Preparation, Utensils Washing Floor Wash, Landscaping, Flushing Bathing & Cleaning, Linen & Laundry cleaning Operation theater, Dialysis Unit

4. Cost Analysis Capital Cost (INR) Deep Bore well/Tube well - 50,000 – 2,50,000 R.O System - 4,00,00 - 7,00,000 U.V System - 50,000 Recurring Cost(INR) Plant O&M - 4 lakhs – 7 lakhs per annum Water cost - 1000 per 12,000 lit tank * - Recurring cost can be significantly brought down by proper professional input at initial planning stage.

6. WATER USAGE AND RECOVERY SYSTEM FOR HOSPITALS Fresh Water tank Treated Water tank Municipal Sewage Treatment Plant Garden

7. Kitchen/ Canteen Linen/ Services Area Out Patient/ Reception Laboratory Services Radiology/ oncology unit Hospital Wards/ Beds Operation Theater 150 lpd 50 lpd 50 lpd 100 lpd 100 lpd 50 lpd 100 lpd Sterilizing & Disinfection agents, pathogens, organic wastes, human tissues, blood Organic wastes, pathogens, sterilizing, & Disinfection Agents Spent liquid isotopes, photo developers, X-ray Developers. Organic wastes, pathogens, antibiotics Detergents, organic wastes Food Wastes, Detergents Organic Wastes Solid Waste Treatment Biological Treatment Physico-chemical Treatment

8. TypicalSTPlayoutforhospitals Chimney Bio Scrubber Chlorine Dosing Pump Air Bar Screen Equalization Tank To Recycle Water Tank Tube Settler Chlorine Dosing Tank ACF PSF Aeration Tank Blower Filter Press Filtrate to Head Works

9. Skid Mounted Water Treatment Plant

10. Concern Areas and Solutions… Odor issues Bio scrubber Plant O & M – break down issues Operate on contractual basis Contamination of treated water line and fresh water line Separate tanks and piping from planning stage Hygiene Depends on maintenance

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13. Need for Onsite Sewage Treatment Liquid wastes in hospitals – no strict guidelines unlike Bio-medical wastes handling. Governmental Regulations becoming increasingly strict Hospital accreditation Fresh water expenses Untreated sewage hauling expenses Land Cost

14. Effluent limits suggested by CPCB

15. Size of hospital and onsite STP requirement DPCC – 500 beds or more TNPCB – more than 50 beds/ dwelling units KSPCB – 200 beds or more(Mangalore).

17. Requires in-depth understanding of technology and design factors

18. Design & Engineering to reduce project cost and implementation risks

19. Optimization of project design for streamlining project implementation

20. Ensures that designer is ultimately responsible for quality performance

21. Higher plant operation efficiency

22. Continued client interaction

23. Least downtime

24. Higher efficiency due to in-depth understanding of assets created

25. Preparation of AMP (asset management plans) for optimizing O&M activities

26. Civil and bought out portion entirely outsourced to dedicated local contractors

27. Technology Integration involves:

28. Piping

29. electrical

30. Instrumentation