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I I I I i I i i I i 1 I I I I I I I 1 <br /> STATE OF CALIFORNIA <br /> DEPARTMENT OF PESTICIDE REGULATION PRODUCTION AGRICULTURE MONTHLY PESTICIDE USE REPORT <br /> PR-ENF-017C(REV.2199) <br /> Instructions: Submit the white cony to the Agricultural Commissioner within 10 days of month following application. <br /> 1 I <br /> 60 <br /> MONTH 1 YEAR 2 , <br /> NURSERY 3 ` <br /> Pap_Z.1L <br /> OPERATOR 101PERMITNUMBER OPERATO (GRIOWER) ADDRESSQ� CITY ZIP CODE <br /> 6� QV /moi V"CAJ`'iyr , T a <br /> SITE IDENTIFICATION NUMBER TOTAL PLANTEOACREAGE/UNITS COUNTY NUMBER SECTION TOWNSHIP NGE BASE&MERIDIAN <br /> 4 '� 10z IOUtt 12 13 5 14 W 15 S N <br /> COMMODITYISITE T EATEDFIELD LOC <br /> ATION f�/�'!`{f <br /> 17 10 L► 1 <br /> CHEMICAL TEME ACREAGEIUNR6 APP. BLOCK 10 EPA OR STATE REGISTRATION NUMBER TOTAL PRODUCT USED DAYB RATE DILUT N PRODUCT AND MANUPACTUR <br /> CODE N1M9ER P171LICATION TREATED METHOD (IF (FROM LASED ICIRCLE ONE UNR REENTRY PERACRE <br /> COMPLETED (CHECK APPLICABLE) OFMEABURE) <br /> 21 22 24 ONE) 25 26 27 29 211) 30 31 <br /> Lam` GR <br /> -71 <br /> ^7 OTHER Q g LB PT OT GA -�r O V /)L4l <br /> GR ❑ <br /> AIR p <br /> OTHER ❑ LB OZ PT OT GA <br /> GR ❑ <br /> A!R ❑ <br /> OTHER❑ LB OZ PT OT GA <br /> GR ❑ <br /> AIR <br /> OTHER LS OZ PT OT GA <br /> OR ❑ <br /> AIR <br /> OTHER H LS OZ PT OT GA <br /> GR ❑ <br /> AIR ❑ <br /> OTHER ❑ LB OZ PT OT GA <br /> GA [ <br /> AIR ❑ <br /> OTHER❑ LB OZ PT OT GA <br /> GA ] <br /> AIR <br /> OTHER LB OZ PT OT GA <br /> GR ❑ _ S( #) s. <br /> AIR i- .)I I". 1 ,f' •}` ` <br /> OTHLA LB OZ PT OT GA <br /> GR Cl <br /> AIR ❑ esy• ' , <br /> OTHER❑ LB OZ PT OT GAI- <br /> n <br /> OR ❑ '•.>: <br /> AIR ❑ <br /> OTHER❑ LB OZ PT OT GA +* <br /> OA <br /> AIR iU'1 t..\'•�� <br /> OTHER❑ LB OZ PT OT GA <br /> GR ❑ <br /> AIR ❑ <br /> OTHER❑ LB OZ PT OT GA <br /> OR ❑ <br /> AIR ❑ <br /> OTHER❑ LB OZ PT OT GA <br /> REPORT PREPARED BYDATE 66 REVIEWED BY <br /> "} '' ,r: ','lt l o ,nPy--Counh! .lgriculiural Comm''ssioner; Fink copy -DPH; Canary--Applicat r G denrod--Applicator FOR AGENCY USE ONLY <br />