SU0004682_SSCRPT - Laserfiche WebLink

Home Browse Search

I d ! ! STATE OF CALIFORNIA DEPARTMENT OF PESTICIDE REGULATION PRODUCTION AGRICULTURE MONTHLY PESTICIDE USE REPORT PR-ENF-017C(REV.2/99) Instructions: Submit the White �cop to the Agricultural Commissioner within 10 days of month following application. AAAV MONTH I1 YEAR 2 NURSERY 3 Page of OPERATOR ID/PERMIT NUMBER OPERATOR(GROWER) ADDRESS CITY ZIP CODE 43� -a3-3a�i 57�rr�I iFA\JCH �153 �, SITE IDENTIFICATION NUMBER TOTAL PLANTED ACREAGE/UNITS COUNTY NUMBER SECTION SECTION /7r TOWNSHIP l RANGE BASE A MERIDIAN 9 �� 10 L� � 11 � l 12 1 { _ j;13 1 N 14 5 S M H COMMODITY/SITE TREATED FIELD LOCATION/arm/ �.-np/'£+ FZD ._w�1�.r+j l�� t2,=.Tt .!T•+^p 17 A LMU�L,619 LA ,-4Ra ^-- G QY� t `I✓G1 w GLS�+ CHEMICAL UATE/TIME ACREAGE/UNrTS APP. BLOCK t0 EPA OR STATE REGISTRATION NUMBER TOTALPROOUCT USED DAYS RATE OILUT104 PRODUCT AND MANUFACTURER COVE NUMBER APPLICATION TREATED METHOD (IF (FROM LABEL) (GRCLE ONE UNIT REENTRY PER ACPF COMPLETED (CHECK APPLICABLE) OF MEASURE) 21 22 23 _ 24ONE) 25 26 27 28 29 30 31 { l� OTHER❑ EPA 726?—23-- oZ T QT 19YZ -1� `•7L�' 4J.&2, G` P V >� a It AIR ER �� LB OZ PT T n1, 2 t cn L5, 0IZC 14/A 6Z 1A! 7 A03AUG R GR AJR�t it OTHER❑ u�� ✓ 1V '..�^�V l � _ LB OZ PT OT 1 OR ❑ AIR OTHER LB OZ PT QT GA AIR L1AfR OTHER H LB OZ PT OT GA GR ❑ An 0 OTHER❑ LB OZ PT OI GA GR ❑ Ain ❑ OTHER❑ _ LB OZ PT OT GA GR ❑ _� AIR OTHER LB OZ PT OT GA GR ❑ AIR ❑ OTHER❑ LB CZ PT OT GA GR n NTL ❑ LB OZ PT OT GA on 8 AIR OTHER❑ LB OZ PT OT GA OR AIR OTHER❑ LB OZ PT OT GA ; a'' R;• GRMR OTHER❑ OZ P7 OT GA LB 1x 'Gs AIR On El OTHER[] LB OZ PT OT GA i) REPORT PREPARED BY DATE REVIEWED BY Form Distribution! White CODY--County Awicultural Commissioner: Pink coot/--DS'�; Ca,,vv--A.ppticator, Goldenrod--Applicator FOR AGENCY USE ONLY