Laserfiche WebLink
fPARTMFNT(OF PEST{,IPE Frn ",TIDr �prlp�r`-1 1RIq... TUFT— KAON - - -LYS. -13710,l U�, HE�H T 1 f <br /> A 7C R� <br /> sttutions: Submit the y to the Agricultural Commissioner within 1 o days of month following application. <br /> 1 <br /> YEAR <br /> NURSERY 3 <br /> �'ERATpR ID/PERMIT NUMBER / <br /> OPERATOR( ROWER} <br /> q 7/f� /) r ADDREEESSSS�� <br /> / i ` `f � 5 —Fe �a'-1,1_v� L Q K 6�7 !^ C, W �1��C� f} CITvPam--l of <br /> -E IDENTIFICATION NUMBER �J [l' ZIP CODE <br /> TOTALPLAN7EDAC AGElUNI75 COUNTY /CC.1( 7 ,F-Ih <br /> CC((,,/((JJ�rjj SECTION TOWNSHIP e <br /> r RANGE MlITE T FATED 10 11 �_/ BASE d MERIDIAN <br /> 12 v�( 13 0 N O E <br /> QQ FIELD LOCATION `) 14 15 S M H <br /> =HEMICAL DAT IME ACREAGElUNITS APP, BLOCK ID 19 J v cv-,{I1 1 V 1 V J� <br /> DE NUMBER APPLICATION TREATED MET NOO (IF EPA OR STATE REGISTRATION NUMBER TOTAL PRODUCT USED !! <br /> COMPLETED (CHECK APPUCABLE) (FROM LABEL) (CIRCLE ONE UNIT DAYS RATE DILUTION <br /> REENTRY PER ACRE PRODUCT AND MANUFACTURER <br /> 2 23 24 ONE) 25 26 OF MEASURE) <br /> /J R GR 77 26IBJ <br /> Jh AIR 30 31 <br /> OTHER <br /> AIR J (J lT^ LEI Z P7 <br /> ! <br /> GR �c5 <br /> r ` <br /> OTHER❑ �� <br /> I GR OT GA��. <br /> LJ LB OZ PT a9Ns ��S <br /> s � <br /> AIR <br /> OTHER B y} � `f�[ �° � ✓ ✓��� I S <br /> OR JOZ PT OT GA !/�/ ./>V'"`/ A7 <br /> ATRE] �f <br /> ! Y W �.✓�F! E 1 S <br /> 3�C OTHER ����j, 6D <br /> fL-'' LB OZ PT OT GA <br /> OR � L.L <br /> f 1 AIR CD <br /> OTHER <br /> Q J, <br /> GR �{ DZ PT OT GA <br /> /L <br /> arr AIR '/�](`J� �5 (� <br /> I OTHER � CIC i � `�V� !'//�y <br /> f � GR (� OZ PT OT GA �,! rj lQ-�QS• oiC�j' i S <br /> AIR <br /> OTHER <br /> GR ❑ zQ ll I 8 OZ PT OT GA ( <br /> -113 <br /> AIR ❑ <br /> OTHER ❑ ` <br /> GR LB OZ PT OT GA <br /> AIR n <br /> OTHER n <br /> GR ❑ LB OZ PT OT GA <br /> AIR 1 <br /> OTHER <br /> GR E LB OZ PT OT GA <br /> AIR <br /> OTHER <br /> I <br /> GR r-7 LB OZ PT OT GA <br /> AIA 1. yrT q'•.a,C <br /> OTHER <br /> GR LB Dz Pr Or GA "`- <br /> MR <br /> OTHER <br /> LB OZ PT <br /> GR or GA Jra AIR <br /> OTHER ❑ <br /> LB OZ PT OT GA 1' <br /> ORT PREPARED BY e <br /> clribution; Whits c0 ty 9 DATE `j REVIEWED BY <br /> PY Coun A riuultuml Commissioner-, Pnk c0pv--PFR. Canary--A,!ll hcalc r, Gn,ur, (c: ', - .,r <br /> FOR AGENCY USE ONLY <br />