Agricultural Flow Meter Approval Form - Georgia Soil And Water Conservation Commission
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2Georgia Soil and Water Conservation Commission
Agricultural Flow Meter Approval Form
(To be completed by GSWCC representative)
Permit or Application Number: ____________________________________________________
Permit Applicant Name: __________________________________________________________
County: _______________________________________________________________________
Date of inspection: ______________________________________________________________
Inspector: ______________________________________________________________________
Type of withdrawal: ____________________surface water ___________________ground water
Power source of pump: __________electric__________diesel_________propane_________other
Well, surface water source, or field name: ____________________________________________
Type of irrigation: _________center pivot _________traveler _________drip _________solid set
Type of crop under irrigation (circle one): Row Crop Orchard
Produce
Turfgrass
Other
Acres irrigated under metered system: _______________________________________________
Make and model of meter: ________________________________________________________
Meter Serial Number: ____________________________________________________________
GPS coordinates of meter: ________________________________________________________
Location of meter: _______________________________________________________________
Diameter of metered pipe: ________________________________________________________
Pipe thickness: _________________________________________________________________
Meter mounting: _________________________Horizontal ________________________Vertical
Pump capacity (gpm or hp): _______________________________________________________
Flow rate (totalizer timing for 10 min.): ______________________________________________
Meter Reading (circle one): ______________Acre. Inches
Gallons
Acre. Feet
Is meter easily accessible? : _______________________________________________________
Has meter been installed as per required specifications? : ________________________________
Were straightening vanes installed? : ________________________________________________
What is the pipe length upstream? : _________________________________________________
What is the pipe length downstream? : _______________________________________________
Was the system in use when inspected? : _____________________________________________
Was a digital photo of meter and surrounding piping taken? : _____________________________
___________________________
Certified by: _______________________
Permit Applicant Signature
GASWCC Representative
According to the Groundwater Use Act (O.C.G.A 12-5-90 et seq., amended), all agricultural withdrawal permits must
have a flow meter installed. Permits issued after July 1, 2003 MUST have a meter installed and approved by the Soil
and Water Conservation Commission before farm use can begin. This form will be completed by a representative of
the Commission and returned to EPD, 531 Main St. Suite D, Tifton, GA 31794.
Revised Nov. 2010
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