Irrigation Evaluation Form

Variance Type

Irrigator Information

Customer Information

Backflow Device
Is there a Backflow Device?*

Controller Information

Is the Controller On or Off?*
Is there a Rain Sensor?*
Program A
Active Days
Program B
Active Days
Program C
Active Days
Verification*

Stations 1-5

Station 1
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 2
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 3
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 4
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 5
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken

Only press the submit button after you have completed all the station information for the system.

Stations 6-10

Station 6
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 7
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 8
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 9
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 10
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken

Only press the submit button after you have completed all the station information for the system.

Stations 11-15

Station 11
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 12
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 13
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 14
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 15
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken

Only press the submit button after you have completed all the station information for the system.

Stations 16-20

Station 16
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 17
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 18
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 19
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 20
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken

Only press the submit button after you have completed all the station information for the system.

Stations 21-25

Station 21
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 22
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 23
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 24
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken
Station 25
Pressure (H or L)
Heads Too Low
Heads Not Vertical
Heads Broken or Missing
Heads Leaking
Nozzle Broken
Nozzle Wrong
Nozzle Clogged
Overspray
Pipe Leaking or Broken

Only press the submit button after you have completed all the station information for the system.

Need to submit additional stations? Use the Irrigation Station Additions form.

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