2 Daily_Pest_app_record.pdf
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- Solicitation number
- 1284LM22Q0018
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20__ DAILY HERBICIDE APPLICATION RECORD
Complete all fields with RED font
Name:____________________ Lic. #:________________ Address:____________________________________ Phone:_______________________
Road # or Treatment Area:__DF or PP (circle one)_ Major Drainage or Area Name:___Plains TIA______
Beginning Lat.__________________ Long._________________________
Ending Lat.______________________Long.________________________
FACTS ID:__________________________ Fund Code:________________
---Circle/Fill-in Appropriate Response--- BEFORE spraying: fill-in blocks 1-14
AFTER spraying: fill-in with block 15 - 17
County Sanders (9) Time ______Start ______Finish
(1) Operator Name (10) Temp. _____° F
(2) Treatment Type
Pesticide Application - 2510 Mechanical/Physical - 2530 Biocontrol, Classic - 2550
(11) Wind speed /Direction (from)
____MPH (N, NE, E, SE,
S, SW, W, NW)
(3) Equipment Code
Handsprayer (711) Backpack (712)
Hand Spreader (714) Mobile Grnd Sprayer (721)
Aerial (731)
(12) Pesticide (chart below) 1 2 3 4 5 6 7 8 9 10 11 12 13
(2) Method Code Manual Chem. (710) Mech. Chem. (720) Aerial Chem. (730)
(13) Product Rate/Ac.
_____oz/Ac (1st pesticide from #12 above)
_____oz/Ac (2nd pesticide from
#12 above)
(5) Weed(s)
Cadr – White top, Canu - Musk thistle, Cest8 -Spotted knapweed,Ciar4 -Canada thistle, Cyof - Houndstongue, Ecvu – Blueweed, Eues - Leafy Spurge, Hiau - Orange Hawkweed, Hipr - Meadow hawkweed,Hype - Goatweed, Levu - Oxeye daisy, Lida - Dalmatian toadflax, Livu2 - Yellow toadflax, Pobo10 - Bohemian knotweed Pore5 - Sulfur cinquefoil, Tavu - Tansy
(14) Surfactant/Adjuvant
Trade Name:____________________
Ingredient_Type:________________
Rate_Applied(oz/ac):_____________
(6) Weed Stage Rosette Bud Flower Fall (15) Total gallons Diluent Applied
_______ gal (From flow meter or graduations on tank)
(7) Site Admin. Site, Campground, Forest, Pasture, Rangeland, Right-of-Way, Riparian, Trailhead, Trail
(16) Calibrated Volume (Gal.
Water/Ac.)
______gal./Ac
(8) Date: ____/____/20____ (17) Area Treated (Ac.)
__________Ac.
Comments:
Product Name Manufacturer
EPA
Registration # Active Ingredient (AI) AI Rate
1 Tordon 22 K/Outpost 22 K Dow 62719-6 Picloram 2 lb/gal 2 Milestone Dow 62719-519 Aminopyralid 2 lb/gal 3 Opti Amine Helena Chem. 5905-501 2,4-Dichlorophenoxyacetic Acid 3.8 lbs/gal 4 Weedar 64, 2, 4-D Amine 71368-1 2,4-Dichlorophenoxyacetic Acid 3.8 lbs/gal 5 2,4-D Amine 4 Agrisolutions 1381-103 2,4-Dichlorophenoxyacetic Acid 3.8 lbs/gal 6 Transline Dow 62719-259 Clopyralid 3 lb/gal 7 Telar Dupont 352-522 Chlorsulfuron .75 oz/oz 8 Escort Dupont 352-439 Metsulfuron .6oz/oz 9 Vanquish Syngenta 100-884 Diacamba 4 lb/gal
10 Plateau BASF 241-365 Imazapic 2 lb/gal 11 Honcho Plus Helena Chem. 524-454 Glyphosate 4 lb/gal 12 Aqua Star Albaugh, Inc. 42750-59 Glyphosate (Aquatic) 4 lb/gal 13 Metcel Agsurf Corp. 352-439-85588 Metsulfuron .4oz/oz
Pg 2 Date ___________ FACTS ID: _____________
Multiple Days of Spraying
Date Time Temp. Wind Speed /Direction
Total Gallons Beginning Lat./Long. Ending Lat./Long. Remarks
Comments:
Map:
| Temp. |
| Ending Lat./Long. |
| Remarks |
| Time |
| Date |
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