Laserfiche WebLink
I f f I 1 I ! I I 1 I I f I I I t 1 <br /> DSTATE EPARTMENT <br /> PRODUCTION AGRICULTURE MONTHLY PESTICIDE USE REPORT <br /> DEPARTMENT OF PESTICIDE REGULATION <br /> PR ENF-UI TC(REV.2100) <br /> Instructions: Submitto the Agricultural Commissioner within 10 days of month following application. <br /> MONTHTH 1 EAR 2 <br /> NURSERY J <br /> 1/� ��J�1M// A ,/ /// A�/�//� Page ���}ol <br /> DPERATORo-3, �VBER O r �j��OR R I� 60D $, /' L! .V��L� 616 CITU / �/" '✓ � ZIP7 G/V <br /> SITE Ni FIC ATION NVMBEfl S TOTAL PLANT 0 ACRE AGENNITS COUNTY NUMBER G SECTION TOWN (B.//� N RANGE ���BASE�_B////MERIDIAN <br /> J 'vy //7 /`/I/-�/ <br /> B 10 11 12 13 5 1d W IS 5 M H <br /> COMMO /SIT T ATED FIELD LO/CAT" / �j / <br /> CJ <br /> 17 _ 10 V , 11,1t <br /> / L`I 1 t <br /> CHEMICAL DATE/TIME AOREAOENNnS APP. BLOCK EPA OR STATE REGISTRATION NUMBER TOTAL PRODUCT USED DAYS RATE DILUTH,N PRODUCT AND MANUFACTURER <br /> r"NUMBER APPLKATION TREATED M"KOO IIF (FROM IASEL) (CIRCLE ONE UNIT REENTRY pEPACNE <br /> COMPLETED (CHECK APPLICABLE) OF MEASURE) <br /> ONE) <br /> 22 23 24 25 26 27 <br /> 2] % % 00 31 <br /> I I I.3 p11 'f LJ OTHER❑ ($'1 <br /> OR <br /> MR <br /> OTHER Q /L-//�� V LB OZ PT OT GA <br /> GR ❑ <br /> AIR ❑ <br /> OTHER❑ LB OZ PT OT GA <br /> OR ❑ <br /> AIR <br /> OTHER LB OZ PT OT GA <br /> aR <br /> MR <br /> OTHER LB OZ PT OT GA <br /> OR BMR <br /> OTHER LJ LB OZ PT OT GA <br /> OR ❑ <br /> MR <br /> OTHER 0 LB OZ PT OT GA <br /> OR ❑ <br /> MR _ <br /> OTHER _ <br /> T GA <br /> _ rte+ <br /> MR <br /> Ec <br /> MR 11 - c J <br /> OR ❑ <br /> OT <br /> rql <br /> OTHER LJ <br /> QLB T GA <br /> OTHER LB DZ PT OT GAOR <br /> DEC', 'i <br /> A <br /> n <br /> SANJQAQUINC ALTY GT GA <br /> OR A . <br /> LB OZ PT OT GA <br /> OR <br /> LB OZ PT OT GA <br /> LB OZ PT OT GA <br /> REPORT PREPARED B DATE�V REVIEWED BY <br /> I Foon Dishibution( Whit co4-- untyAgikulturalCorn6ssionor; Pink ropy--DPR; Canary--App Icator, Golds wd-Appiic star FOR AGENCY USE ONLY <br />