Irrigation Form

Contact Information

* First Name

* Last Name

Company Name

* Billing Address

* City

* State

* Zip Code

Mobile Number

* Email

Service Address (if different from billing)

Service Address 1

Service City 1

Service Address 2

Service City 2

Service Selection

Start-Up

Installation of pump (if required), suction hose, or backflow preventer. Check each zone for damaged parts. Timer set for spring watering.

$190/hour — One Hour Minimum | $180/hour if prepaid by April 15

Winterization

Blow out lines with air compressor. Remove pump/backflow. Note any repairs to be made in spring.

$180/hour — One Hour Minimum (Pay when invoiced in the fall)

Please remove me from the list, I no longer require these services

When will you be notified of your date of service?

Approximately one week in advance you will receive a call, email or text to schedule your appointment.

To prepay your irrigation, select the Pay Bill button on the top ribbon of our website after submitting this form.

We are committed to protecting your privacy at Gilford Well Company. We will not collect any personal information from you that you do not volunteer, and we are the sole owner of all information collected on this site. We do not sell, share, or rent this information to others in any way.