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JILL(C-1130/R-11.23/H-11.25/D-2.3) User:Haley Flying Service 9/24/20 10:36:42AM Version:7.7 <br /> STATE OF CALIFORNIA - ENVIRONMENTAL PROTECTION AGENCY <br /> DEPARTMENT OF PESTICIDE REGULATION <br /> • PESTICIDE USE REPORT (33-025 Rev 3/90)PMIS 0033 <br /> Rec.#M13-APL-01126-1 <br /> ( ) Nursery <br /> County Section Township Range Base&Meridian Method Permittee/Customer Applicator Name&Address <br /> 39 16 O I S 05E M G A M FARMS HFS Inc. <br /> Operator Identification Number Site Identification Number Planted Area P.O. BOX 1049 <br /> 39-13-3900051 1-2 33.00 ac TRACY,CA 95378-1049 <br /> Location Block ID AM 1-2-I ASP <br /> W HOWARD 3/4 MI W UNDINE* 13 <br /> Date/Time Applied Area Treated Commodity or Site Treated Crop ID <br /> Proposed:09/20/13 0700 Actual <br /> Actual: 09/23/13 0900 33.00 ac ASPARAGUS 16002-00 <br /> Restricted Chemical Registration Number Total Formulated Rate Per Dilution <br /> Material Number I Product and Manufacturer From Label Product Used ac Volume <br /> N 0 Activator 90 Surfactant 34704-50034-AA 1.24 4.80 30.00 <br /> UAP-Loveland Industries al oz gal <br /> N 253 Lorsban Advanced 62719-591-AA 8.25 2.00 30.00 ASPARAGUS <br /> Dow Agrosciences gal pt gal <br /> Days Reentry Days Preharvest Application Supervised By NW N NE <br /> 24 hr 1 day 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 9/24/201. 10:36 AM Lew Baumbach 4700 <br /> Received By: Box No. Date Time Approved <br /> Denied <br /> OCT o8 <br /> FD <br /> AGq COMM SToCkTQIU <br />