Irrigation Pump Speed Controller Pre-App

Irrigation Pump Speed Controller Pre-Application Form
Let's get started

Instructions: Please fill out this Pre-Application Form to get started. We will review your information and respond to you by email to confirm your irrigation pump meets the incentive program eligibility requirements.
Do your irrigation flows change throughout the season?
Do you have a 5 HP or larger irrigation pump?
Customer Information
Your Name

First NameLast Name
Service Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Email
Irrigation Pump Information
Meter number
The six-digit number on your bill or on the meter.
Are there other pumps on this meter?
If yes, please explain.
Is the pump control located inside a protected enclosure or is it exposed to the elements?
How is the existing discharge pressure controlled?

Other
Pump motor horsepower (HP)
Pump operating pressure (PSI)

Estimate the flow rate interval and/or percentage of maximum flow

Rows	0%	10%	20%	30%	40%	50%	60%	70%	80%	90%	100%
% of Time

Irrigation Pump Speed Controller Pre-Application Form