A00810-610544.pdf

PDF 874 KB Posted

Attached to
610544 PEABODY FAP No. CMQ/STP/TAP-0034(034)X Multi-Use Path Construction of Independence Greenway
Solicitation number
BD-27-1030-0H100-0H002-132023
Issued by
Essex County, Massachusetts

About this file

This is a MassDOT Herbicide Use Report form for the Massachusetts Department of Transportation Highway Division related to Proposal No. 610544-135966, dated July 18, 2018. The form is designed to document herbicide applications performed by contractors on state highway projects and serves as a reporting mechanism for the MassDOT District Engineer and Landscape Design Section in the Boston office. The document is associated with the Peabody FAP No. CMQ/STP/TAP-0034(034)X Multi-Use Path Construction project known as Independence Greenway.

The form requires contractors to document all herbicide products used, including EPA registration numbers, active ingredient percentages for both dry and liquid formulations, dilution rates, and additional products such as surfactants. The report mandates detailed information about treatment applications, including the contractor name, applicable town(s), associated route, project description, treatment description, targeted weeds, application methods, acreage treated, square yardage or mileage of coverage, and precise date and time records for when treatment began and ended. The form specifically addresses Early Detection Rapid Response (EDRR) invasive species including Japanese Knotweed, Hogweed, Pepperweed, and Kudzu, with particular attention to Tree of Heaven management in stands exceeding twenty trees or when located near nurseries, landscape companies, or highway rest areas. Applicator license numbers must also be recorded on the report, which must be submitted upon completion of work to both the District Engineer and the Landscape Design Section.

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Other files

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A00801-610544.pdf PDF
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Text version

Massachusetts Department Of Transportation Highway Division

A00810 - 1

DOCUMENT A00810

MassDOT Herbicide Use Report

Proposal No. 610544-135966

07/18/2018

Use multiple sheets for multiple application techniques or sites as needed.

Product Used:

Upon completion, please submit form to MassDOT District Engineer and Landscape Design Section in Boston office.

MassDOT Herbicide Use Report Date Submitted:

Name: _____________________

EPA Reg. No: _______________

% Active Ingredient

Dry: ___________________

Liquid: _________________

Formulation (dilution rate): _______________

Name: ______________________

EPA Reg. No: _______________

% Active Ingredient

Dry: ____________________

Liquid: _________________

Formulation (dilution rate): _______________

Name: _____________________

EPA Reg. No: _______________

% Active Ingredient

Dry: ___________________

Liquid: _________________

Formulation (dilution rate): _______________

Additional products used (surfactants, etc.) or other information:

Applicators: License Numbers:

* Please note:

EDRR Species (MAM, Hogweed, Pepperweed, Kudzu, etc.)

Tree of Heaven 1) stands of >20 trees; 2) >5 trees near nursery, landscape company, or highway rest area where trucks stop

Contractor Performing Work:

Town/s:

Project or Contract No:

Associated Route:

Project Description:

Treatment Description:

Weeds Targeted:

Application Method:

Acres:

Gallons Formula Used:

Date/Time Began:

Date/Time End:

Area Treated (as applicable)

Sq Yds: Miles:

MDAR ALERT*:

A00810 - 2

Proposal No. 610544-135966

A00810 MassDot Herbicide Report 07-18-2018

File details come from the government source that posted it. Updated .