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I .I I I I I I 9 I I I I 1 I I I I f 1 <br /> STATE OFDEPARTMENT <br /> NTOFRNIA PRODUCTION AGRICULTURE MONTHLY PESTICIDE USE REPORT <br /> DEPARTMENT OF PESTICIDE REGULATION <br /> PR-ENF-017C(REV.2199) <br /> Instructions: Submit the.white conn to the Agricultural Commissioner within 10 days of month following application. <br /> 7')'I A 2- 7 C:r,o <br /> MONTH 1 YEAR 2 <br /> NURSERY 3 <br /> Page-Of <br /> OPER]A[TO�R IDIPERMIT NUMBER OPERATOR JGRJ_OWER) -pot <br /> ADDRESS �p p CITY /� ZIP CODE �� <br /> 4 .J f Jr ,") --39(��,? 2 5 q�TE!��j� �i/o/` 6 (114(V E. C�00r9,P1066 P-0 7 '-{C-Arn!'"tt B T�-21-V <br /> SITE IDENTIFICATION NUMBER F TOTAL PLANTED ACREAGE/UNITS COUNTY NUMBER SECTION TOWNSHIP / � RANGE BASE A MERIDIAN <br /> 9 :3 -L,- 110 2 �� 11 � 112 -3-2, 13 LT 5 14 W 1b S M H <br /> COMMODITYISITE TREATED FIELD LOCATION <br /> 17 c�vw,ro'ee , 19o (3P-IDLE X4 ITlf. r <br /> CHEMICAL DATE/TIME ACREAGEA)RITS APP. BLOCK 10 EPA OR STATE REGISTRATION NUMBER TOTAL PRODUCT USED LAYS RATE DILUTION PRODUCT AND MANUFACTURER <br /> CODE NUMBER APPLICAVOK TREATED METHOD (IF {FROM LABEL) (CIRCLE ONE UNIT REENTRY PER ACRE <br /> COMPLETED (CHECK APPLICABLE) OF MEASURE) <br /> 21 22 23 24 ONE) 25 26 27 2B 29 30 31 <br /> all <br /> ?Q ? OTHER❑ j.� �- .Z � LB OZ j QT GA R1212- <br /> ' > �- <br /> GR <br /> AIR <br /> 7&? OTHER❑ 1 ? z LB OZ PT OT GA �J(t v 7 <br /> AIR El <br /> r OTHER L] �1E1 C.x LB 0 PT OT GA iADt <br /> Oa ❑ <br /> NR ❑ <br /> OTHER❑ LB OZ PT OT GA <br /> GR ❑ <br /> NR ❑ <br /> OTHER❑ LB OZ PT OT GA <br /> GR [] <br /> NR ❑ <br /> OTHER[] LB OZ PT OT GA <br /> GR ❑ <br /> AIR ❑ <br /> OTHER❑ LB OZ PT OT GA <br /> OR <br /> AIR <br /> OTHER g LB OZ PT QT GA <br /> GRAIR <br /> I' <br /> OTHER❑ LB OZ PT OT GA <br /> t�PP .1 0 <br /> Ga ❑ - <br /> ua ❑ <br /> OTHER❑ LB OZ PT OT GA <br /> [] <br /> AIR <br /> ❑ I �,� <br /> OTHER❑ LS OZ PT QT GA <br /> GR ❑ <br /> NR (� <br /> OTHER❑ LB OZ PT OT GA <br /> OR gMR <br /> OTHER❑ LB OZ PT OT GA <br /> OR 01 1 <br /> AIR ❑ <br /> OTHER(] LB OZ PT OT GA <br /> .I <br /> REPORT PREPARED 13Y — - �[ � DATE / ` (-� REVIEWED BY <br /> -:�siP': 3t::tlil�I.1[inn: b'lFi3a1 C(p} f 'oombjAgricul IT7lcOTTIITIISS"IOT1aT; f IP12:copy....f"KT Gni-onroa`'-_-`..7.TI7)1r.7c. FOR AGENCY USE ONLY <br />