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FATE'OF CAI-14 1 ( DEPARTMENT OF PESTICISU9ATION <br /> Ill SUMMARY PESTICIDE USE REPORT ENFORCE1 J•BRANCH m <br /> IV <br /> P2 :NF-060(REV.08108)Page 1 of 6 m <br /> II- 'RUCTIONS FOR COMPLETING THIS FORM ARE INDICATED BELOW AND ON THE REVERSE SIDE `o <br /> L <br /> Com- OR(FIRM NAME) ADDRESS CITY ZIP CODE PHONE NUMBER � <br /> _--i e C - 1 O /!/- u�/' -.�c. G� ��+ 'ted 32 Z U crr <br /> 0- tA70R I0IPERMIT KUMBE LICENSE NUMBER COUNTY'NIIERE APPLIED COUNTY NUMBER 4tOr� WEAR OF USE TOTAL U61BER OF APPLICATIONS <br /> F' <br /> LD <br /> !. )rnplete Columns A,e,C,and D for A!1 Users <br /> 2�amnlete_GniLrmn-E hy.ruing-crna ria`flre.fnllnwtng-+�r+rly<. <br /> Uode 40 - Structural Pest Control.......................•...........includes any pest control work performed within or on buildings arld other structures. <br /> code 30 - Landscape Maintenance Pest Control.............includes any pest control work performed on landscape plantings around residences or other buildings,yotf courses,parks,cemeteries,etc. m <br /> LO <br /> erode 40 • Right-of-Way Pest Control...............................includes any pest control work performed along roadsides,power lines,median strips,ditch banks,and similar sites. W <br /> Code 50 - Public Health Pe=st Control...............................includes any pest control work performed by or under contract with State or local public health or vector control agencies. <br /> ode 80 - Vertebrale Pest Control....................................includes any vertebrate pest control vrork performed by public agencies or work under the supervision of the State or county agricultural commissioner. <br /> erode 91 Commodity Fumigation(Nonfood lonfeed).....includes fumigation of nonfoodlnoafeed commodities such as pallets,dunnage,furniture,burlap bags,etc. N <br /> t.wode 100 - Regulatory Pest Control.................................includes any pest control work performed by public employees or contractors in the control of regulated pests. ego <br /> 3,:L'ompiefe Columns Fend G,if use does n fit one of the above codes <br /> z A B C D E F G <br /> 0 <br /> MANUFACTURER A,ND EPAICALIFORNIA REGISTRATION NUMBER FROU LABEL TOTAL PRODUCT USED NUMBER OF CODE COMMODITY OR SITE ACRESIUNI Is <br /> NAME OF PRODUCT APPLIED INCLUDE ALPHA CODE (Cirde Ore Unit of Measure) APPLICATIONS TREATED TREATED <br /> -e o l 9 1 - LS OZ PT QT GA l (,;� ros zeo <br /> S !PW ©cc, LB OZ FT QT C. / l r0 <br /> V0� LB O QT ( f G <br /> 6 114I �r <br /> r LB OZ PT QT G <br /> LB OZ PT OT GA <br /> LBOZ PT QT GA <br /> LB OZ PT QT GA- <br /> r� <br /> , OA �111.GAgg 001 <br /> LB 02 PT OT GA `�Nt 4 5V,' <br /> T> <br /> 0-I <br /> LB OZ PT QT GAJ TTl <br /> CS) <br /> Ul <br /> LB OZ PT QT GA <br /> G) <br /> REPORT PREPARED BY DATE <br />