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I I i I i i i I i I I I i i I i I i I <br /> STATE OFCACALIFORNIA <br /> DEPARTMC.",T PRODUCTION AGRICULTURE MONTHLY PESTICIDE USE REPORT I <br /> OF OF PESTICIDE REGULATION r <br /> PA-ENF-017C(REV.2/98) <br /> Instructions: Submit the White copy to the Agricultural Commissioner witnin 10 days of month following application. <br /> MO�U- �G 1 YEAR 2 <br /> NURSERY 3 <br /> Page of <br /> OPERATOR ID/PERMIT NUMBER OPERATOR(GROWER) ADDRESS _ 'Ty <br /> ZIP GOOF <br /> 5 �d ,L���G►�q 6 wo b�1\� 7 ��,,_, e sa w <br /> SIT 10 NTIFICATION NUMBER TOTAL PLANTED ACAEAGElUNITS COUNTY NUMBER SECTION TOWNSHIP ANGE `f BASE 6 MERIDIAN <br /> {Jy 0 / E <br /> 9 — 1D 11 S �^C 13 14 15 S M H <br /> COMMODITY/SITE TREATED FIELD LOCATION <br /> CHEMICAL DATE7TIM ACREAGElUNFr4 APP. BLOCK 10 EPA OR STATE REGISTRATION NUMBER TOTAL PRODUCT USED DAYS RATE D UTION PRODUCT AND MANUFACTU <br /> CODE NUMBER APPLICATIO TREATED METHOD S1F (FROM LABEL) (CIRCLE ONE UNIT REENTRY PER ACRE <br /> CO MPL£TED {CHECK APPLICABLE) OF MEASURE) <br /> 21 22 23 24 ONE) 2S 26 27 28 29 30 �31 <br /> AI 2 J I <br /> .J OTHER hj S� OZ P1 '1T QT GA /� D& ✓," P7 Yet j"�qf I a{��✓ ✓✓ S <br /> �' OuoTRHER o 3 -�d B DT4 T GA 3 /a 1 4 f�� - ✓- ,�/l <br /> l AIR <br /> GR <br /> All,ID1 OTHER ❑ s � R O�z PT QT GA <br /> GR <br /> r OTHER AIRf B OZ PT OT GA �i& vas✓ SC S{1 S `�L+` V1LJ <br /> GR <br /> OLj <br /> T'R}1ER ❑ �5- D'} �" LB �� OT GA �� ��'S, aZ,,�- ��� � eAIR ✓ <br /> 1OR <br /> • SOTHER ❑ oras-� ���- LB i�POT GA p/tfvv <br /> GR ❑ - <br /> AIR El <br /> OTHER ❑ LB OZ PT OT GA <br /> GR {] <br /> AIR ❑ <br /> OTHER ❑ LB OZ PT QT GA -. <br /> GR ❑ <br /> AIR . f <br /> OTHER p LB OZ PT OT Ga °+. J) 1 <br /> • <br /> GR ❑ <br /> AIR ❑ <br /> OTHER❑ <br /> LB OZ PT OT GA <br /> GR ❑ <br /> AIR ❑ <br /> OTHER❑ LB OZ PT OT GA ,p f 1 A <br /> OUM <br /> GRAIR -❑ r - <br /> OTHER,r❑] LB OZ PT QT GA A::T21L�- l•�mfA.•LOD1 <br /> GH <br /> AIR <br /> OTHER❑ LB OZ PT OT GA <br /> GR ❑ <br /> AIR <br /> OTHER LB OZ PT OT GA <br /> REPORT PREPARED BY LQi�G DAVE REVIEWED BY <br /> Form Distribution: White copy--County Agricultural Commissioner; Pink copy—f7PR; Canary--Applic nr; G I'orirc : Appb�a;nr FOR AGENCY USE ONLY <br />