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N dnesday, July 16, 2003 PMIS-0188B <br /> rev.02/28102 <br /> Pesticide Use Report <br /> Nursery County Section Township Range Base&Meri7MethodE <br /> me 8 Address <br /> 39 26 1S 8E Mation <br /> 3r} ermitee/Customer Operator ID/Permit# Site ID# 95361 <br /> 39-03-3902345 VEENSTRA 3- <br /> 3 r Block ID(if applicable) <br /> .ota/Acres Planted Location <br /> 255.00 S/E LONE TREE &CARROLTON RDS. <br /> )ate 8 Time Applied AreaTreated Commodity/Site Treated <br /> 7/14/03 11:15 88.00 ac. Corn <br /> Product 8 <br /> -Zhemical# Manufacturer EPA Re .# Total Applied Rate er Acre Dilution <br /> 4450 COMITE 00400-00104-ZA-00000 176.00 PT 2.000PT 10 <br /> 10 GALLON AIR CHARGE 0.00 AC O.000AC 10 <br /> lours Reentry Days Preharvest Application Supervised by: Shane Sperry <br /> 0 30 Yellow W/green <br /> Submitted by Date: Time: <br /> ROSALYN SPERRY 07/16/2003 12:14 pm <br /> Received by Box No Date Time <br /> submit to AGRICULTURAL COMMISSIONER within 7 days of application <br /> yy y T12/ <br /> f7 <br /> 03 <br /> til"' �e <br />