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JELL(C-1135/R-11.27/H-11.26/D-29.4) User:Haley Flying Service 7/3/201 2:28:09PM Version:7.8 <br /> STATE OF CALIFORNIA - ENVIRONMENTAL PROTECTION AGENCY <br /> DEPARTMENT OF PESTICIDE REGULATION <br /> PESTICIDE USE REPORT (33-025 Rev 3/90)PNIIS 0033 <br /> #M14-APL-00618-1 <br /> ( ) Nursery <br /> County Section Townshipj Range Base&Meridian Method Permittee/Customer Applicator Name&Address <br /> 39 21 OIS I 05E M A A M FARMS HFS Inc. <br /> Operator Identification Number Site Identification Number Planted Area P.O.BOX 1049 <br /> 39-14-3900051 1-7B 46.00 ac TRACY,CA 95378-1049 <br /> Location Block ID AM 1-7134 CORN <br /> HOWARD RD RANCH* 14 <br /> Date/Time Applied Area Treated Commodity or Site Treated Crop ID <br /> Proposed:07/03/14 1125 Actual <br /> Actual: 07/03/14 1230 40.00 ac CORN FORNODDER. 22005-00 <br /> Restricted Chemical Registration Number Total Formulated Rate Per Dilution <br /> Material Number Product and Manufacturer From Label Product Used ac Volume <br /> N 0 Activator 90 Surfactant 34704-50034AA 0.50 1.60 10.00 <br /> UAP-Loveland Industries al oz gal <br /> N 2303 Onager 10163-277-AA 5.00 16.00 10.00 Tw_o-spotted Spid� <br /> Gowan gal oz gal <br /> Days Reentry Days Preharvest Application Supervised By NW N NE <br /> 12 hr 30 day I Gary Del Carlo <br /> Environmental Changes/Comments <br /> • W E <br /> Target Area <br /> Submitted By: Date Time PCA Name SW S SE <br /> Denis Della Nina 7/3/2014 02:28 PM Lew Baumbach 4700 <br /> Received By: Box No. Date Time A proved <br /> Denied <br />