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I I I i i I I I 1 I 1 <br /> STATEOF IFORNIA <br /> DEPARTMENTTMENTOF PESTICIDE REGULATION PRODUCTION AGRICULIrURE MONTHLY PESTICIDE USE REPORT <br /> PR-ENF-017C(REV.2199) <br /> Instructions: Submit the.white cop to the Agricultural Commissioner within iA days of month following application. <br /> MONTH 1 YEAR 2 <br /> NURSERY 3 <br /> Page of <br /> OPERATOR IDIPERMIT NUMBER �f 3 OPERATOR(GROWER) j� ADDRESS`' �y CITY yy� ZIP CODE <br /> 4_ <br /> 31 11-f _'6y Ga IL�T i,l 5 �C ve I-) .f✓o 1 g <G,-40�i � �f l� 7 //// is <br /> SITE IDENTIFIICCjATION NUMBER TOTAL PLANTED ACREAGE/UNITS COUNTY NUMBER SECTION TOWNSHIP RANGE BASE R MERIDIAN <br /> 9 �" �, 1❑ -� 11 12 13 S 14 W 15 S M H <br /> COMMODITY/SITE TREATED FIELD LOCATION <br /> W c he(-rIe,, 18 <br /> CHEMICAL DATEITIME ACREAGE)UNITS APP, BLOCK ID EPA OR STATE REGISTRATION NUMBER TOTAL PRODUCT USED DAYS RATE DILUTION PRODUCT AND MANUFACTURER <br /> CODE NUMBER APPLICATION TREATED METHOD (IF (FROM LABEL) (CIRCLE ONE UNIT REENTRY PER ACRE <br /> COMPLETED (CHECK APPLICABLE) OF MEASURE) ` <br /> 21 22 23 24 ONE) 26 27 28 29 30 31 <br /> AIR <br /> f� <br /> HER❑ <br /> �J .� .` , LB&PT a GA fj) + m i?i1S <br /> Ai <br /> NR "l <br /> . .� OTHER❑ n l•r' _ <br /> v c _ E OZ PT OT GA <br /> .� j GR <br /> a <1800Z <br /> AS <br /> OTHER❑ q��fT�" `1`J LB Z PT OT GA I(rt! `1� e <br /> AI /y 5� <br /> i�,�kQ • � 4 � OTHER❑ �� �G JIC y LB O PT OT GA <br /> GR ❑ <br /> AUR <br /> OTHER LB OZ PT OT GA <br /> GR <br /> AIR H <br /> OTHER ❑ LB OZ PT OT GA <br /> OR ❑ <br /> AIR <br /> OTHER❑ LS OZ PT OT GA <br /> OR ❑ <br /> AIR ❑ <br /> OTHER❑ LB OZ PT QT GA <br /> NR El <br /> OTHER❑ LB OZ PT OT GA <br /> GR ❑ Ail0H I <br /> AIR p - 11O <br /> OTHER d LB OZ PT OT GA <br /> GR ❑ <br /> AUR ❑ ir:., .'I,,, <br /> OTHER❑ LB OZ PT OT GA 1 <br /> OR SAIR <br /> OTHER❑ LB OZ PT OT GA <br /> GR <br /> AIR <br /> OTHER❑ LB OZ PT OT GA <br /> GR ❑ <br /> NR ❑ <br /> OTHER❑ LB OZ PT OT OA <br /> 1 ��e <br /> REPORT PREPARED BY_ - ' -'�4'- ..._, DATE REVIEWED BY <br /> F,,,I H Vvhitn Copy -Ck.; y A -rIC-Ui 'Mi Co nims'sioGer; Pink copy--DPR; Cnnar)..-:zppliratov; Qoldmri�# -`');;IIIc"--': FOR AGENCY USE ONLY <br />