Irrigation System Sanitation Checklist
Complete this checklist to ensure proper sanitation and maintenance of the irrigation system.
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Location of Irrigation System
*
Inspector's Full Name
*
First Name
Last Name
Type of Irrigation System
*
Please Select
Drip
Sprinkler
Surface/Furrow
Center Pivot
Other
Sanitation Checklist
*
Rows
Completed
Needs Attention
Not Applicable
System flushed with clean water
1
2
3
Filters/screens cleaned
4
5
6
Tanks/reservoirs sanitized
7
8
9
Pipes/hoses checked for debris
10
11
12
Chemical injectors flushed
13
14
15
Nozzle/emitters cleaned
16
17
18
Backflow prevention device inspected
19
20
21
Were there any issues found during the inspection?
*
Yes
No
If issues were found, please describe them
Corrective Actions Taken (if any)
Upload photos or supporting documents (optional)
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Additional Comments or Observations
Inspector's Signature
*
Submit Checklist
Submit Checklist
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