SECTION A

Job Name

Crop Type -- Select options -- Agave Alfalfa Almonds Apples Asparagus Avocado Banana Barley Bean Beet Berries Blueberries Broccoli Cannabis Carrot Cebollin Chilies Citrus Clover Cocoa Coffee Corn Cotton Date palm Dragon Fruit Eggplant Fig Flowers Garlic Ginger Grain Grapes Greenhouse cucumbers Greenhouse peppers Greenhouse tomatoes Hazelnuts Hemp Japanese Persimmon Jicama Kiwi Lemon Lime Macadamia Mango Melons Oil palm Olive Onions Orange Papaya Pasture Peach Pear Pecan Pistachios Pitaya Pomegranate Potatoes Rice Sorghum Soybeans Strawberry Sugarcane Sunflowers Sweet potatoes Table grapes Tomato Turmeric Walnuts Watermelon Wheat Wine grapes Other

Netafim Manager

Project Type - Please Select - New Customer New Area for Existing Customer Design Check only Other

Existing Job Number

SECTION B (End User details)

First Name

Last Name

Email Address

Mobile Phone

I am - Please Select - Agri Investor Business Partner Consultant Dealer Designer Distributor Government Grower Journalist NGO Researcher Supplier Student Other

Company Name

Country - Please Select - Australia New Zealand

State or Province - Please Select - General Australia Mildura New South Wales New Zealand General Northern Territory Queensland South Australia Tasmania Victoria Western Australia

Street Address

Postcode

SECTION C (Property/Site details)

Property Name *

Property Full Address

Contact Person Full Name

Contact Person Email Address

Contact Person Mobile

Netafim Dealer

Dealer Contact Name

Dealer Phone Number

Dealer Email

SECTION D (Design Details)

Will a scaled plan of area be uploaded (see upload all relevant files in section F)?

Yes No

Will contour information with legible heights be uploaded (see upload all relevant files in section F)?

Yes No

Is there existing pipe work / infrastructure that needs to be taken into consideration?

Yes No

Is pump station new?

Yes No

Are existing pump details enclosed?

Yes No

Are row directions marked on plan?

Yes No

Are headland or roadway dimensions and position clearly shown?

Yes No

Are mainlines running through blocks acceptable?

Yes No

Is the water source and its RL marked on the plan?

Yes No

What type of irrigation is required? -- Select options -- Drip SS Drip Micro Sprinkler Sprinkler Other

Mainline Pipe

PVC PE FlexNet Other

Submain Pipe

PVC PE Other FlexNet

Are dripline flushing manifolds required?

Yes No

Mainline sizing, which will govern system operational flexibility:

Min ($) Med ($$) Max ($$$)

Row spacing? (METRES)

Plant spacing? (METRES)

Emitter details?

Flow of emitter? (L/HR)

Spacing of emitters? (METRES)

Number of laterals per row?

What is the water source

Dam Bore River Other Canal

What flow rate is available for the project (m3/hr)?

What is the preferred primary filtration?

Gravel Disc Screen Other

SECTION E (Soil and water analysis details)

Has a soil survey been submitted for consideration in the design? Yes/No

Yes No

If NO, does the customer want us to ignore soil variation when designing?

Yes No

Has water analysis data been submitted for consideration in the design? Yes/No

Yes No

If NO, does the customer want us to ignore water quality when designing?

Yes No

Are shift requirements enclosed?

Yes No

Are crop and variety breakups indicated?

Yes No

To what extent is irrigation-related drainage mitigation important?

Low ($) Med. ($$) High ($$$) N/A

Section F

Crop water requirement per day (mm)?

Time window for pumping?

Pump power supply; eg single phase, diesel - Please Select - Single Phase (240V) Three Phase (415V) Diesel Solar Other

Max design flow variation (FV) - Please Select - 0% (Pressure Compensated) ±5% (10%) ±7.5% (15%) ±10% (20%) N/A

Comments/Additional Information:

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