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Ir U r r r r r r r r r r r r r r U- STATE OF CALIFORNIAPRODUCTION AGRICULTURE MONTHLY PESTICIDE USE REPORT DEPARTMENTOF PESTICIDE REGULATION PR-ENF�017C(REV-ON) instructions: Submit thewhite the Agricultural Commissioner within 10 days of month following application. MUNIH YEAR 2 NURSERY 3 Page_DI OPERATOR G OWER) I ` ADDRESS CITY ZI CODE r OPERATOR ID/PERMIT NUMBER l `L `j)E 56 7 S 917E IDENTIFICATI NNUMBEfl TOTAL PLANTS D ACREAGE/UNITS COUNTY NUMBER SECTION '}�" TOWNSHIP NOE A5EA MERIDIAN r• �-/ 13 f N 14 15 5 M H 8 1 10 �� t1 FIELD LOCATION COMMODITY/SITE TREATED / 10 • OIJIVJNy�Av'p� ( I�+laf9/Y.i7L7/ 17 CHEMICAL T ME ACREAGEAINRS APP. BLOCK ID EPA OR STATE REGISTRATION NUMBER TOTAL PRODUCT USED OAY9 RATE DILUTION PRODUCT AND MANUFACTURER CODENUMBER APPLICATION TREATED METHOD (IF (FROM LABEL) (CIRCLE EONE UNIT REENTRY PER ACRE COMPLETED (CHECK APPLICABLE) 21 22 23 24 25 26 'yT) /}�x/�'�j�J 27 29 29 30 31 �. 1 —� �,/' V `-' LB OZ PT OT GA UP AIR M W OTHER❑ ONMR ❑ OTHER❑ LB OZ PT OT GA OR ❑ AIR ❑ OTHER❑ LB OZ PT OT GA OR ❑ AIR OTHER LS OZ PT OT GA OR ❑❑ AIR 8 LB OZ PT OT GA OP MR OTHER ❑ LB OZ PT OT OA DR p❑p OITHER❑ LS OZ PT OT GA OR ❑ NR OTHER H LB OZ PT OT GA OR ❑ NR ❑❑ Meg❑ LB OZ PT OT GA OR ❑ �� 2� uw.uv AIR OTHER❑ LB OZ PT OT GA GR SEP 3 0 '999 OTHER❑ LB OZ PT OT GA OR OTHERMR H LB OZ PT OT GA MM -STULK10N OR AIR OTHER❑ LB OZ PT OT GA OR AIR \� f ,oTHER LS OZ PT OT GA REPORT PREPARED BY Y I �` „ Ir I" L l O Oc u'Lam- DATE Q REVIEWED BY FOR AGENCY USE ONLY Form Distribution: White copy--County Agricultural Commissioner; P c copy--DPR; Canary--Appliceto ; GDIde rod--A plicator