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t ( t I f I I 1 STATIC OF CALIF014NIA 1 I f I 1 I f 1 <br /> DEPARTMENT OF PESTICIDE REGULATION <br /> PRODUCTION AGRICULTURE MONTHLY PESTICIDE USE REPORT <br /> ,�S1iv� K U D 3 <br /> MO TH 1 YEAR 2 <br /> O NURSERY 3 <br /> Page of— <br /> OPERATOR ID/PERMIT NO. OPERATOR (GROWER) ADDRESS CITY ZIP CODE <br /> 3 - 3�?4/,OZ; 7- $ l��sN 6 /�5�04 �_�� 'ew 7 /� B7 S3,fl� <br /> $ITE ID NO. /��s TO AL PLANTED ACREAGE/UNITS COUNTY NO. SECTION F TOWNSHIP RANGE �/ ^ BASE & MERIDIAN <br /> AJ 10 /OL 11 J 12 / 13 z 14v0 L/Ycw) 15 S M H <br /> FIELD LOCATION <br /> COMMODITY/ ITE TREATED 19 z—CIIEIKI <br /> 17 � <br /> NU..AL DATE/TIME A T.E.T UNITS APP. BLOCK ID EPA/CALK. REG. NO. FROM LABEL TOT/.L DAIS PATE DILUTION PRODUCT/MANVFACTUNEP <br /> NUMIER APPLICATION TPEATED METH. IIF PRODUCT OUSEDNE <br /> REEHTPY PER <br /> ACRE <br /> COMPLETED ICHECN APPLICABLE( (CIRCLE ONE UNIT <br /> 21 22 23 24 NEI 25 26 27 OF MEASURE) 28 29 30 31 <br /> GR / <br /> 1-17- AIR <br /> OTHER❑ �f- [ - T / L8 OZ PT OT GA �/ /y`� <br /> (I v OTHER❑ LB�O T OT GA O i <br /> GR it, <br /> AIR ❑ LO (,0f7 <br /> n - J � . A <br /> GR ❑ <br /> AIR ❑ <br /> OTHER❑ LS OZ PT OT GA <br /> GR ❑ <br /> AIR ❑ <br /> OTHER❑ LB OZ PT OT GA <br /> GR ❑ <br /> AIR ❑ <br /> OTHER❑ LB OZ PT OT GA <br /> OR ❑ <br /> IIFElOTHER❑ LB OZ PT OT GA <br /> GR Cl <br /> AIR ❑ <br /> OTHER❑ LS 02 PT OT GA <br /> GR ❑ <br /> AIR ❑ <br /> OTHER❑ LB OZ PT OT GA <br /> GR ❑ <br /> AIR ❑ <br /> OTHER❑ LB OZ PT OT GA <br /> GR ❑ <br /> AIR ❑ <br /> OTHER❑ LB OZ PT OT GA <br /> GR ❑ <br /> AIR ❑ 1.V'♦1„ .1 <br /> OTHER CI <br /> LB OZ PT OT GA <br /> OR ❑ <br /> R N <br /> ITHER❑ LB OZ PT OT GA A� .`r-� <br /> l <br /> GR ❑ , <br /> AIR ❑ tlp:.• r.r ]iiS:.wprn <br /> OTHER❑ LB OZ PT OT GA y {f ) <br /> AR ❑ <br /> OTHER❑ LB OZ PT OT GA <br /> REPORT PREPARED BY -`���/.�./}1 DATE ��—�D� REVIEWED BY <br /> Submit to Agricultural Coj <br /> > ssioner within 10 days of month following application PR-ENF-017C (Rev 1/95) For Agency Use Only <br /> HI �+4n <br />