HerbicideApplicationDataSheet.doc

DOC document 49 KB Posted

Attached to
Non-Native Invasive Plant Control Federal contract opportunity
Solicitation number
AG-55N9-S-16-0005
Issued by
Department of Agriculture Forest Service R9-Eastern Region

About this file

ATTACHMENT 5 SAMPLE DAILY LOG

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Text version

Daily Log – Pesticide Application

USDA Forest Service, Region 9 Date: ________ Sheet: ____ of _____ State/County: ___

Wayne National Forest

Phone: 740-753-0101 /FAX 740-753-0118 Location Description: ____________________________________________________________________________________

Contractor Information (if applicable) Application Equipment Used: _________ Acres Treated: _________________ Name: ____________________________ Type of Application:

Applicator/Operator (print): License No:

Address: ____________________________ Agricultural Weed

Invasive Herbaceous (Foliar)

Phone: ____________________________ Bark/Stump Application

USDA FS Representative: Cheryl Coon Other ________________

Weather
Start
End
Target Species - Common Name/Scientific Name
Monitoring Notes

Date___________ Observer_________

Time

1.

Wind Velocity (mph)

2.

Wind Direction: (N NE E SE S SW W NW)

3.

Temperature (F()

4.

Precipitation (inches)

5.

Condition [S-sun] [C-cloudy] [PC-partly cloudy]

6.

CHEMICAL AND ADJUVANT SUMMARY (* if not applicable to adjuvants)

Common Name

(e.g. Round Up Pro) Commercial

Formulation

(e.g. Glyphosate)

EPA

Reg. #r Restricted

Use Pesticide

(Y/N) % Active

Ingredient (AI) in formulation

(lbs/gal)

Carrier/ Dilutant
Ounces of product used
Application Rate 1:

% Formulation in Tank Mix*

Application Rate 2: lbs AI/Acre*
Ounces adjuvant

/gallon

Total Volume Applied: Gallons Tank Mix
Total AI applied (lbs AI)

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