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STATE OF CALIFORNIA - ENVIRONMENTAL PROTECTION AGENCY <br /> DEPARTMENT OF PESTICIDE REGULATION <br /> PESTICIDE USE REPORT(33-025 Rev 3/10)PMIS 0033 <br /> Rec.#00604-M05--AP1-1 <br /> ( ) Nursery <br /> County Section Township I Range Base&Meridian Method Permitte/Customer Applicator Name&Address <br /> 39 12 01S 09E M I G RAYMAR FARMS Kuil Brothers <br /> Operator Identification Number Site Identification Number Planted Area 22844 S.Frederick <br /> 39-05-3903404 1-4 100.00 ac Ripo%CA 95366 <br /> Location Block ID 14C <br /> N/DODDS FJHIE.NRY <br /> Date/Time Applied Area Treated Commodity or Site Treated Crop ID <br /> Proposed:07/05/05 Actual <br /> Actual: 07/05/05 6:00 am 90.00 ac Corn/Field 22005-0 <br /> Restricted Chemical Registration Number Total Formulated Rate Per Dilution <br /> Material Number Product and Manufacturer From Label Product Used ac Volume <br /> N 1855 Gly Star Original 42750-60-AA 2.2.50 2.00 <br /> Albau;�h Inc. tgal <br /> �l 253 Lorsban 4E-HF 62719-220-AA 22.50 2.00 <br /> Dow Agroscienm 99t <br /> N 5130 Shark Herbicide 279-3194-AA 1.56 0.3300 <br /> FMC Corporation lb oz gal <br /> Days Reentry Days Preharvest Application Supervised By NW N NE <br /> 24 hr 35 day Matt Kuil <br /> Environmenta[Changes!Comments <br /> W E <br /> Target Area <br /> Submitted By: Date Time PCA Name SW S SE <br /> Matt Kuil 07/28/05 1:32PM ED VERMEULEN 6654 <br /> Received By: Box No. Date Time Approved <br /> Denied <br /> E C E I V E <br /> AUG 0 A 7005 <br />