Att 03 Post-Application Documentation Form.pdf

PDF 59 KB Posted

Attached to
Sapling Release, Gap Creation and Invasive Species Control at the Trimbelle and Rush River Sites in Pierce County, Wisconsin.
Solicitation number
W912ES20Q0002
Issued by

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Other files

File Type Posted
Amendment 3 W912ES20Q0002.pdf PDF
Amendment 1 W912ES20Q0002.pdf PDF
Amendment 2 W912ES20Q0002.pdf PDF
Att 04 Approved Herbicide List.xlsx XLSX spreadsheet
Rush River PWS W912ES20Q0002.pdf PDF
Att 02 Prescription TrimbelleRush_TreatmentArea.pdf PDF
Rush River RFQ W912ES20Q0002.pdf PDF
Att 01 TrimbelleRush_VicinityMap.pdf PDF

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POST-APPLICATION DOCUMENTATION FORM

PEST CONTROL PROGRAM

U.S. ARMY CORPS OF ENGINEERS, ST. PAUL DISTRICT

1114 South Oak St., La Crescent MN, 55947

Ph. 651-290-5899

APPLICATION INFORMATION

APPLICATION DATE: ______________________

CONTRACTOR: _________________________________ APPLICATOR: ___________________

Addr: ___________________________________________ Addr: ___________________________

City: ____________________________________________ City: ____________________________

Phone: ___________________________________________ Phone: __________________________

TARGET PEST: ______________________________________________________________________

DATE OF TIME OF AIR RELATIVE WIND DIRECTION ACREAGE

APPLICATION DAY TEMP HUMIDITIY CLOUD COVER AND SPEED TREATED

DESCRIPTION OF TREATED AREA:

PESTICIDE INFORMATION

PESTICIDE (TRADE NAME): _________________________________________________________________________________________

FORM APPLIED: _____________________________________________________________________________________________________

ACTIVE INGREDIENTS:

EPA REGISTRATION: _____________________________________ EPA CLASSIFICATON: ______________________________________

HOW THE PESTICIDE WAS MIXED: ____________________________________________________________________________________

APPLICATION RATE (TOTAL): ________________________ APPLICATION RATE (ACTIVE) __________________________________

INGREDIENT (S) : __________________________________________________________________________________________________

APPLICATION EQUIPMENT USED:

AMOUNT APPLIED: _________________________________________________________________________________________________

DISPOSAL INFORMATION DISPOSAL DATE: ____________________________

METHOD: _________________________________________________________________________________________________________

LOCATION: _________________________________________________________________________________________________________

ADDITTIONAL REMARKS: ____________________________________________________________________________________________

APPLICATION INFORMATION
PESTICIDE INFORMATION
APPLICATION DATE:
CONTRACTOR:
APPLICATOR:
Addr:
Addr_2:
City:
City_2:
Phone:
Phone_2:
TARGET PEST:
undefined_2:
undefined_3:
undefined_4:
undefined_5:
undefined_6:
DESCRIPTION OF TREATED AREA:
NAME:
FORM APPLIED:
EPA REGISTRATION:
EPA CLASSIFICATON:
HOW THE PESTICIDE WAS MIXED:
APPLICATION RATE TOTAL:
APPLICATION RATE ACTIVE:
INGREDIENT S:
APPLICATION EQUIPMENT USED:
AMOUNT APPLIED:
DISPOSAL DATE:
METHOD:
LOCATION:
ADDITTIONAL REMARKS:
ACTIVE INGREDIENTS:
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