A06_PAR_Template.pdf
PDF 216 KB Posted
- Attached to
- GOLD BUTTE HERBICIDE Federal contract opportunity
- Solicitation number
- 140L3924Q0090
About this file
This document is the Pesticide Application Record for the Gemini Solar Project in Nevada. It provides details on the pesticide application, including the applicator information, application methods, pesticides used, application conditions, the targeted pest species, and a monitoring record. The document indicates that this record must be completed within 24 hours of the pesticide application and retained for a minimum of 10 years. This record is required for the Gemini Solar Project, which is referenced in the related federal contract opportunity for "Gold Butte Herbicide" solicited by the Department of the Interior, Bureau of Land Management Nevada Region.
View the file
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| Sol_140L3924Q0090_Amd_0001.pdf | ||
| Sol_140L3924Q0090.pdf | ||
| A06_Chemical_Pest_Control.doc | DOC document | |
| A04_SOW.docx | DOCX document | |
| A06_OPM-35.pdf | ||
| A06_Herbicide_SOP.pdf | ||
| A06_Map.pdf | ||
| B03_SCA_Wage_Determination.pdf | ||
| A06_DOI-Covered-UAS-Assessment-Guide-v4_0.pdf |
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Text version
APPENDIX J
UNITED STATE DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT
PESTICIDE APPLICATION RECORD
State: Nevada Date of Application: __________________________________
County: Clark County Start Time: ______________ End Time: _________________
Field Office: Las Vegas Project Name: _Gemini Solar Project_____________________
Location of Treatment Site: Operator: _______________________________________
Pesticide Use Proposal Number:__________________________
NEPA Reference Number: _____________________________
1. APPLICATOR:
a. Applicator/Employee(s) Name – Name, License #, Certifying State/Organization:
Name of Applicator(s) License # Certifying State
2. APPLICATION:
a. Delivery Method: (Circle One) Aerial Ground
b. Equipment Used: ______________________________________________________
c. Treatment Coverage Pattern: (Circle One) Broadcast Banded Spot
d. Mix Diluent: (Circle One) Water Oil None
e. Calibration Rate: Liquid Sprayer: ______________________________, or
Granular Applicator: ______________________________
f. For Spot Applications Only:
1. Total Amount Mix Applied on Treatment Site: _________________________
g. Distance to Water: (Circle One) 0 to 10 feet 10 to 25 feet 25 to 100 feet Greater than 100 feet
3. PESTICIDE(S) and ADJUVANT(S) APPLIED:
a. Trade Name: ________________________________________________________________
b. Company/Manufacturer’s Name: _____________________________________________
c. EPA Registration Number: _______________________________
d. Pesticide Common Name: _____________________________________________________
e. Pesticide Formulation Type: (Circle One) Liquid Dry – DF, WDG, etc. Granular
f. Rate of Application – Per Acre:
i. Formulated Product: _________________________________________________
ii. Active Ingredient/Acid Equivalent: _____________________________________
4. APPLICATION CONDITIONS:
a. Wind Speed: ____________________ b. Wind Direction: ___________________
c. Air Temperature: ___________________ d. Humidity: __________________
d. Soil Surface Conditions: (Circle One) Dry Moist
5. APPLICATION AREA:
a. Area Treated – Total Area Treated: ________________________________ Acres.
b. Actual Area Treated – Based upon Chemical Used or Amount of Chemical Applied (Spot
Treatments): ___________________________________________________________
c. Status of Application Site (Circle One): Native Vegetation Seeded Vegetation
Other Type
6. TARGETED PEST(S):
Species Estimated Species Code Species Common Name Phenology Percent Cover
7. MONITORING RECORD:
NOTE:
1. This record is required and is to be completed, except for monitoring, within 24 hours following application of the pesticide.
2. This record must be kept on file/maintained for a minimum of 10 years.
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| Date of Application: |
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| Project Name Gemini Solar Project: |
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| Pesticide Use Proposal Number: |
| a ApplicatorEmployees Name Name License Certifying StateOrganization 1: |
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