6100-XX4 Annual Reporting Form Irrigation Partner

OMB Control Number 2040-0272
Approval Expires XXXX

Irrigation Partner Annual Reporting
EPA WaterSense® Program Partners: Please complete and submit to WaterSense by March 1, 2011.
Section I: General Information
Name: _______________________________________________________________________________________
Name of Company/Organization: __________________________________________________________________
Email: ___________________________________ Telephone: ___________________Fax: ___________________
What type of irrigation work do you do? (check all that apply)
 Irrigation System Design
 Commercial

 Irrigation System Installation/Maintenance

 Residences

 Irrigation System Auditing

 Inactive (e.g., academic, manufacturer)

 Other (Please describe):

Section II: Water Efficient Practice
Please indicate what water efficiency measures you took in the design, installation, maintenance, or audit of irrigation
systems in 2010.
System Design/Installation
Installed a rain sensor shut-off device to prevent watering during and after rain.



Specified or installed a WaterSense labeled a weather- or sensor-based irrigation controller.



Installed drip or low volume irrigation emitters.



Used matched precipitation nozzling.



Ensured overlapping, head-to-head coverage for efficient and uniform water distribution.



Planned zones according to plant type and their water needs.



Installed sprinkler heads according to the plant type and size and shape of the landscape.



Installed low angle nozzles in windy areas to lessen water loss.



Used the proper pipe sizing to ensure uniform operating pressure and even water application.



Installed check valves to prevent low head drainage in sloped areas.



Installed a flow sensor to automatically shut off a system in the event of a break.



Ensured correct pressure and flow rates are applied to avoid misting or fogging, using pressure
regulating devices when applicable.
Encouraged customers to consider non-potable water sources for landscape irrigation.



Other (Please describe):





System Maintenance
Routinely checked sites for damaged sprinkler heads, inadequate coverage, clogged nozzles, and leaks.



Ensured that the application rates were adjusted to avoid runoff.



Adjusted sprinkler heads as needed to avoid overspray.



Set the schedule to irrigate using short cycles to allow water to soak in to avoid runoff.



Developed written operation and maintenance instructions for customers including watering schedule,
seasonal adjustments, winterizing, and spring reactivation.
Performed audits of customer sites to ensure efficient operation.



Recommended upgrade to systems to make them more water efficient (e.g., drip irrigation, installation by
WaterSense labeled controllers)
Other (Please describe):





System Audits
1. If you perform irrigation audits, what types of properties did you audit in 2010?

Section III: Control Technologies
1. Do you specify or install weather- or sensor-based irrigation control technologies?
 Yes  No
If yes, approximately how many controllers did you install in 2010? _______________________________

Section IV: Water Savings Data
1. Do you track water savings data from water efficiency measures?
 Yes  No
If yes, approximately how many gallons of water did you save in 2010 through efficient system design,
maintenance practices, or audit recommendations? _____________________________________
Additional Explanation:

Section V: WaterSense Program Feedback (Optional)
In the interest of serving you better, EPA would like to learn more about your opinions regarding the WaterSense
program and information needs. Please complete the following section to provide feedback to EPA.
1. On a scale of 1 to 5 (5 = most valuable), how valuable do you find the WaterSense program? Value: ___________
How has WaterSense added value? ______________________________________________________________
2. On a scale of 1 to 5 (5 = most valuable), how valuable did you find the materials from the tool kit?
Value: ______

3. Please provide suggestions for improving the WaterSense program (e.g., tools/materials, communications,
Helpline, Web site, etc): ________________________________________________________________________
___________________________________________________________________________________________

Please submit to the WaterSense Helpline by March 1, 2011.
Fax: (703) 841-1440
Mail: 2300 Wilson Blvd., Ste. 350, Arlington, VA 22201
Electronically: If you have Adobe Acrobat Standard or Professional, you can complete the form electronically and
e-mail it to [email protected]. Acrobat Reader users must print forms after completing and fax or mail them.
Contact the WaterSense Helpline at (866) 987-7367 if you have any questions about how to complete this form or
submission instructions.
EPA Form Number 6100-XX
The public reporting and record keeping burden for this collection of information is estimated to average 18 hours per response. Send comments on the
Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including
through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200
Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed annual data form to this
address.