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I I I 1 I ) i 1 I I I 1 1 1 I 1 I I 1 <br /> STATE OF CALIFORNIA <br /> DEPARTMENT OF PESTICIDE REGULATION PRODUCTION AGRICULTURE MONTHLY PESTICIDE USE REPORT <br /> PR-ENF-OI7C(REV.2199) <br /> Instructions: Submit the•white copy to the Agricultural Commissioner within io days of month following application. <br /> dwL-- <br /> M(5NTq 1 YEAR 2 <br /> NURSERY 3 <br /> Page_of <br /> OPERATOR ID/PERMIT NUMBER OPERATOR(GROWER) ADDRESS CITY ZIP CODE <br /> SIS' —{DEI TIFICATION NUMBER TOTAL PLANTED ACREAGEIUNITS COUNTY NUMBER SECTIONWNSHIP RANGE BASE&MERIDIAN <br /> 9 2 10 11 12 13 � S i4 E=!Ej15 3 M H <br /> COMMODITY/SITE TREATED FIELD LOCATION <br /> 17 � �� /� 19 V -0c—A-- x: <br /> CHEMICAL DATE/TIME ACREAGENMRS APP. BLOCK 10 EPA OR STATE REGISTRATION NUMBER TOTAL PRODUCT USED DAYS RATE DILUTION PRODUCE ANUFA <br /> A MCTURER <br /> CODE NUMBER 1 APPLICATION TREATED METHOD (IF (FROM LABEL) (CIRCLE ONE UNIT REENTRY ERACA <br /> COMPLETED (CHECK APPLICABLE) OF MEASURE) <br /> 21 22 23 24 ONE) 25 26 27 Q 28 29 30 31 i <br /> GR O <br /> AIR <br /> t ;2' OTHER❑ °7 - LB O PT OR <br /> OT GA <br /> AIR 0 <br /> ❑ � RR <br /> OTHER❑ LB OZ P OT GA I <br /> OR ❑ <br /> AIR ❑ <br /> OTHER[] LB OZ PT QT GA <br /> GR ❑ <br /> AIR <br /> OTHER LB OZ PT OT GA <br /> GR ❑ <br /> AIR <br /> O7H� LB OZ PT QT GA <br /> GR ❑ <br /> AIR ❑ <br /> OTHER❑ LB OZ PT OT GA <br /> GR [] <br /> AIR ❑ <br /> OTHER❑ LB OZ PT OT GA <br /> GR L] <br /> AIR <br /> OTHER H LB OZ PT QT GA <br /> GR <br /> AIA <br /> OTHER❑ LB OZ PT QT GA <br /> OR ❑ <br /> AIR ❑ <br /> OTHER❑ LB OZ PT QT GA I? <br /> OR ❑ - 7.f+.` w <br /> NR Cl <br /> OTHER[I LB OZ PT OT GA <br /> AIR <br /> OTHER[I LB OZ PT QT GA <br /> GR <br /> AIA <br /> OTHER L] LB OZ PT QT GA <br /> OR p <br /> AIR ❑ <br /> OTHER❑ LB OZ PT OT GA <br /> REPORT PREPARED BY ���� DATE / `r �� REVIEWED BY <br /> �i•.�Is� Di-iijImfln!l: FIkIhtfo co;�v--•;Otlnk)l Agf1CIA14ural C:oMmisslan®E; Pink CO)TH--))PPS Conor}'-_g�prlic�stor; i c;lra��;;Y-:,�.1-..'�_'•���ii..:.s;:: FOR AGENCY USE ONLY <br />