SU0005331 SSCRPT - Laserfiche WebLink

Home Browse Search

I IF I I I I I I I 1 1 4 1 9 V r - STATE OF CALIFORNIA PRODUCTION AGRICULTURE MONTHLY PESTICIDE USE REPORT DEPARTMENT OF PESTICIDE REGULATION PR-ENF-017C(REV.21") instructionas::Submit the white 0012 to the Agricultural Commissioner within 10 days of month following application. MONT1 AwH 1 YEAR NURSERY 3 Page_of OPERATOR ID/PERMIT NUMBER OPERATOR(GROWER) ADDRESS CITY ZI CODE 1 5 g t c 63 T 5dn 5 SITE IDENTIFICATION NUMBER TOTAL PLANTED ACREAGEIUNITS COUNTY NUMSECTION TOWNSHIP NGE VASE A MERIDIAN ^ / i1 1q,4 5S M N In 112 13 COMMODIYSRAD FIELD LOCATION w ^ CHEMICAL ME ACREAOENNIIS APP. BLOCK EPA OR STATE REGISTRATION NUMBER TOTAL PRODUCT USED DAYS RATE DILUTION PRODUCT AND MANUFACTURER CODE NUMBER APPLICATION TREATED METHOD (IF (FROM LABEL) (CIRCLE ONE UNIT REENTRY PERACRE COMPLETED (CHECK APPLICABLE) OF MEASURE) 21 22 23 r^-ry.� 24 ONE) 25 26 27 28 241 9 30 31 AR -k /�//j�'/j t OTA 4V- OTHER❑ �, -- f 3 (� LB OZ PT OT GA O I'�`^""' DR gAIR OTHER❑ LS OZ PT OT GA OR ❑ AIR ❑ OTHER❑ LB OZ PT GT GA OR ❑ AIR OTHER H LB OZ PT OT GA OR ❑ AIR OTHER H LB OZ PT OT GA OR 8AIR OTHER ❑ LB OZ PT OF GA MR OR ❑ OT ❑ OTHER❑ LR OZ PT OT OA DA ❑ AIR OTHER LB OZ PT OT GA OR ❑ MR OTHER LB OZ PT OF GA """1y' 4. vx OR ElGM/. v. . AR OTHER LB OZ PT OT GA OR 8 NN SEP 3 01999 OTHER❑ LS OZ PT OT GA OR AIR ne OTHER❑ LB OZ PT OT GA OR AIR OTHER❑ LB OZ PT OT GA OR ❑ AIR \, OTHER�//� LB OZ PT OT GA REPORT PREPARED BY Y iiGlt r r"' �� 1�` -�- ✓ P DATE O REVIEWED BY Form Distribution: White copy--County Agricultural Commissioner, P copy--DPR; Canary--Applicato , Golde rod--Apiicetor FOR AGENCY USE ONLY