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STATE OF^.ALIF6 A ( DEPARTMENT OF PESTICID ,ULATION <br /> 1�aNTHLY SUMMARY PESTICIDE USE REPORT ENFORCE BRANCH <br /> F- =NF-060(REV.08108)Page 1 of 6 m <br /> L- TRUCTIONS FOR COMPLETING THIS FORM ARE INDICATED BELOW AND ON THE REVERSE SIDE � <br /> (��2ATOP(FIRM lE) ADDRESS CITY Z]P CODE PRONE NUMBER m <br /> G ORATOR IQPERMIT NULIBER CENSE NUMBER COUNTY W7IFRE APPLIED COUNTY NUMB° iIoNJtVEAR OF USE '�� TOTAL NUMBER OF APPLICATIONS � <br /> r,,, r� <br /> —39'037Y- Lo <br /> - <br /> 1 omplete Columns A,B,C,and D for All Users <br /> �`.�omrlatel"olurnn�b�uairg-one-at:hsr-�Iiatrl:rg�oGas:- <br /> ('•ode 10 - Structural Pest Control.....................................includes any pest control work perforrnad within or on buildings and other structures. N <br /> o:ode 30 - Landscape Maintenanoe,Pest Control.............includes any past conlrol work performed on landscape plantings around residences or other buildings,golf courses,parks,cemeteries,etc. LD <br /> 6,ode 40 _ Right-of-Way Pest Control includes any pest control work performed along roadsides,power fines, median strips,ditch banks,and similar sites. W <br /> (,ode 50 Public Health Pest Control...............................includes any pest control work performed by of under oontract with State or local public health or vector control agencies. o <br /> unty agriwttural oomnission er_ <br /> - ;nde BO - Vertebrate Pest Control....................................Includes any vertebrate pest control work Wormed by public agencies or>,vo+under the supervislan of tine State or co <br /> -, N <br /> ;�,;ade 9i - Commodity Fumigation(NonfoodlNonfeed).....includes fumigation of nonfoodlnonfeed commodities such as pallets,dunnage,fumilure,burlap bags,etc_ W <br /> .Includes any pest control work performed b ublic employees or contractors in the control of regulated pests. °J <br /> ,-".ode 100 - Regulatory Pest ConUol...........................__.. P Y P / <br /> 3�.nmplete Columns F and G,if use S&gS not fit one of the above codes <br /> z A B C D E F G <br /> 0 <br /> MANUFACTURER AND EPAfCALIFORNIA REGiSTRATtON NUMBER FROM LABEL TOTAL <br /> PRODUCTUSED NUMBER OF COOS COMMODITY OR SITE ACRESI N <br /> NAME OF PRODUCT APPLIED INCLUDE ALPHA CODE (Circle One Unit of Measure) APPLICATIONS TREATED TREATED <br /> _.n <br /> S0 B OZ PT OT GA <br /> ,I t d ' <br /> 1 ' ?". Qd- GA <br /> rp <br /> _ D <br /> LB Q <br /> �sj ! 9' <br /> b L4- — �0� ie OZ�� OT GA <br /> �' <br /> 1f �. LB r(5p OT GA412-5a-CJO <br /> LS OZ PT QT GA <br /> q 11 <br /> :LS :OZ:PT :QT GA l <br /> LB OZ PT OT GA 0 <br /> 1 <br /> M <br /> LS OZ PT OT GA <br /> m <br /> A <br /> LB OZ PT QT GA G) <br /> G) <br /> DATE <br /> REPORT PREPARED BY /jij <br />