Exhibit_04A_SCNF_Master_Application_Record_North_Zone_Final_022016.pdf
PDF 57 KB Posted
- Solicitation number
- AG-02NV-S-16-0033
About this file
Exhibit 4A
View the file
Other files
Show all 20
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
2016 SCNF IDIQ Exhibit 4A: Salmon-Challis National Forest
311 McPherson Street, Salmon, ID 83467 Inventory_______________
North Zone Herbicide Application Record FACTS________________
This Record is Required by Law and Must be Completed within 24 Hours of Herbicide Application
GPS File: Infestation ID: FACTS ID:
Site Description
Treatment Area Name/Location: Date(MM/DD/YY):
Site Type: Admin.________
Rec. Site_______
Forest_________
Riparian_______
Rangeland_______
Pasture__________
ROW__________
Trailhead_______
Other
(Specify)_____________________________
Application Information Prof. Applicator/License No:_____________________________ Prof. Applicator/License No:____________________________________
Prof. Applicator/License No: _______________________________ Prof. Applicator/License No:___________________________________
Other Applicators:
Equipment
Used: Backpack ______
ATV _____
Truck _____
Mechanical _____ Temp. Range: _________ to _________
Application Time: to Distance to Water: <15ft._____ 15-50 ft._____ >50ft._____ >100ft._____
Wind Speed: Wind Direction: Precipitation: Treatment Type: Broadcast Spot
Target Species: Non Target Vegetation:
Herbicide/Adjuvant Usage
Product Active Ingredient
EPA
Reg. #
Calibration
Rate
(Gal/Acre)
Rate
Applied
(Oz./Acre)
Total
Volume
Applied
(Gallons)
Amount
Applied
(Ounces)
Acres
Treated
(Chemical)
Total
Treatment
Area
(Acres)
Milestone Aminopyralid 62713-519
Plateau Imazapic 241-356
Telar XP Chlorsulfuron 352-654
Tordon 22K Picloram 62719-6
Transline Clopyralid 62719-259
2, 4-D
LI 700 /SS 7000
R11 / S-90/ NIS
MSO / SylTac
Bullseye Dye
Plant Phenology (Dominant Life Stage)
TX APPLICATION VISUAL MONITORING -Total App. Hours ______ Were any adverse effects identified during the application? (# People x total hrs worked)
No Yes (if yes, explain in the Notes) -Total Person Days ______ (Total App. Hours ÷ 10 Hrs)
NOTE- If adding more than 1 herbicide to a tank make sure to display it in Herbicide Name column. (For example: Telar + 2, 4-D)
Record initial amount mixed, gallons used, amount leftover @ end of day & amount applied by Person.
Herbicide Name Initial Amount Mixed Gallons Used Amount Leftover
TOTAL
Record specific amount of herbicide output by NRIS Site ID (If in a new infestation take a Weed Pt; if in a known infestation take a Qwik Pt ) NRIS ID/Plant Code Herbicide Gallons NRIS ID/Plant Code Herbicide Gallons New Species/Location Herbicide Gallons
Mechanical Treatment: Circle type (Pull, Clip Seed heads,)
NRIS ID Quantity Tx NRIS ID Quantity Tx Notes: (e.g. site description, weed cover, and density, water sources, hazards, etc.
Plant Code Phenology (Dominate)
Amount Applied by Person
Name Volume (Gal)
File details come from the government source that posted it. Updated .