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DEPARTStATF ENT OF <br /> PRODUCTION AGRICULTURE MONTHLY PESTICIDE USE REPORT <br /> DEPARTNENF OF PESTICIDE EIEGULhT1CVf <br /> PR-ENF-017C(REV,2W <br /> instr tions:, ubmit the mite cop v to the Agricultural Commissioner within ?a days of month following application. 00 <br /> 7 � <br /> LO <br /> I - <br /> MONTH I YEAR 2 IJ <br /> CF) <br /> NURSERY 3 CSI <br /> Ul <br /> Page of L <br /> OPERATOR INPEF107 NUMBER OPERATOR{GRUYVER) ADORES$ CITY ZIP CODE <br /> �cqANW 3 ,e Chtttuci4/dtk 116961rc, � � g N <br /> SITE IDENTIT$CATION NUMBER FUTALPLANTED <br /> j(ACC19FAGE/UHITS IGNUN7YNUMBER SECTION ITCWNSHIP ANGE BASEAMEFTIC?AN <br /> 12 <br /> 8 Ta V L/ 1i ^ 13 5 14 15 S H <br /> COMWXIITYISI 71E TREATED FIELD LOCATION W <br /> L LJ <br /> -+ <br /> 17 10. <br /> rJ <br /> tXE111CAL GATEf11 E J ACRE IGElUNRS App. h7wo(lp EPAOR STATE FEL STPAMN NUM6EA TUTrL PROMGT USED DAYS RATE NCN PRODUCT.SND YANLIF;G R CiJ <br /> CODE AUMKP APFUCATION TREATED METHOD IIP {Fkobi L"LU (CIRCLE ONE UNTT REENTRY FER ACRE OD <br /> ODNPLETEA {CHECK AFPUCARI-C CPMLASURE) <br /> 21 22 23 24 aYEI 2S 26 27 215 29 31) 31 <br /> d AJR <br /> GR <br /> r-6 OZ PT OT GA ®tile, �-�Ktr <br /> f , 7 O iER Q 4 I � � OZ"'PTQqT GA <br /> GFL 0 <br /> Aat9 [} <br /> OTIiER LB OZ PT OT GA <br /> pi ❑ <br /> OTFIEA Ll LB OZ PT OT GA I <br /> GIR <br /> AIR CJ UI <br /> —_ vrNEx(] LB CZ PT OT GA Z <br /> 419 AJR L i <br /> OTHER E] j Q <br /> --- <br /> LB OZ PT OT GA Ji <br /> GR <br /> AIR Lj H <br /> GTHEA ❑ Z <br /> LB OZ PT 13T GA <br /> GR ❑ 0 <br /> AIR iJI O <br /> aLHER F j LB OZ FT OT GA C- <br /> GH `+n <br /> AIR Li W11.S { <br /> OT?1ER !lI�TTT1111�C77 <br /> LB OZ PT OT GA <br /> GA <br /> AIR <br /> vr14E9❑ LR OZ PF OT GA � YO <br /> QUIN COUNT IV <br /> GR uAD <br /> AIR n <br /> GTHER L] LB OZ PT OT GA <br /> GR ❑ <br /> A1R n <br /> OTHER(U LB OZ PT OT GA <br /> GR J <br /> AIR ( i <br /> f 07TiER n I _U <br /> kB OZ PT OT GA Jj <br /> \ ,A Ln] I M <br /> ON ❑ LE OZ PT OF GA CID <br /> l G d. Za LL(=4 let <br /> AEPORT PREPARED BY _ DATE �� Q REVIEWED g) <br /> Form Distribution: White co CCommissioner; Pink copy—DM Cana FOR AGENCY USE ONLY <br /> Py- oun A ricullural• ty g ry- Applicalo Gold nrad�-Agplicalar <br />