Attach 5 Applicaion Example.pdf

Per BLM policy, Pesticide Application Records must be completed within 24 hours of pesticide application.

Pesticide Application Record (PAR) Contract or Agreement Number:140L0620C0014

Bureau of Land Management Elko District BLM Project Name: Crane Spring Herbicide Weed Treatment

3900 Idaho St Elko, NV 89801 Company Name: Weeds Gone Buh Bye, LLC.

TREATMENT INFORMATION

Date (ex: 6/1/2014)

6/5/2020 BLM PUP # (Refer to page 2 for a list)

NVE000-19-009-P and NVE000-19-008-P Weather Reading time (START):

8:00 AM

Temperature °F:

RH %:

Wind Direction:

Southwest

Wind Max mph:

Wind Avg mph:

Weather Reading time (STOP):

5:00 PM

Temperature °F:

RH %:

Wind Direction:

South

Wind Max mph:

Wind Avg mph:

Nevada Licensed Applicator Name, License Number AND Crew Members

Nevada Licensed Applicator and No.: John Doe, #516009 Crew Members (5): Jane Austin, George Washington, Jack White, & Anna Smith

Mix Diluent (circle one)

WATER

OIL

NONE

Equipment Used (circle one)

TRUCK – ATV – UTV - BACKPACK – AIRPLANE - HELICOPTER – HANDHELD SPRAYER – WICK/WIPER – MOWER

TRACTOR – HORSEBACK SPRAYER

Sprayer Calibration Rate (ex: 2 GALLONS/ACRE) (circle appropriate Rate)

GALLONS/ACRE

POUNDS/ACRE

Distance to Water (circle one)

0 TO 10 FEET

10 TO 25 FEET

25 TO 100 FEET

GREATER THAN 100 FEET

Delivery Method (circle one)

AERIAL – GROUND Spray Pattern (circle one)

BROADCAST – SPOT

Mix Amount Applied on Site (ex: 2 GALLONS)

800 GALLONS Total Acres Treated: 40 Swath Width of Equipment (Broadcast Only) (ex: 50 FEET; NA for SPOT)

NA

FOR LINEAR FEATURES ONLY (i.e. road or stream)

Buffer Width NA Buffer Width Units FEET Buffer Direction (circle one)

LEFT - CENTER - RIGHT

Note on Buffer Direction: left or right will buffer in only one direction, while center will buffer both sides based on the width and units provided. For instance a right buffer of 10 feet will buffer 10 feet on the right only while a center buffer of 10 feet will buffer both sides of the centerline (total buffer is 20 feet)

CHEMICAL BRAND(s) APPLIED - In formulated product units

CHEMICAL TRADE

NAME (ex: Roundup

Pro, Overdrive)

MANUFACTURER

(ex: MONSANTO, BASF)

EPA REG #

(ex: 524-475, 7969-150)

CHEMICAL

COMMON NAME

(ex: Glyphosate, Dicamba + Diflufenzopyr)

RATE OF APPLICATION

Liquid ex: 2 QUARTS PER ACRE, , 8 FLUID OUNCES

PER ACRE, 1 PERCENT SOLUTION

Dry ex: 0.50 POUND PER ACRE, 1 OUNCE PER ACRE

Tordon 22k DowAgro Sciences 62719-6 Picloram 16 fluid ounces per acre

Escort XP Bayer Environmental Sciences

432-1549 Metsulfuron methyl 1 ounce per acre

ADJUVANTS BRAND(s) APPLIED - In formulated product units

ADJUVANT BRAND NAME

(ex: DYNE_AMIC)

MANUFACTURER

(ex: HELENA CHEMICAL)

RATE OF APPLICATION

Liquid ex: 2 QUARTS PER ACRE, , 8 FLUID OUNCES PER ACRE, 1 PERCENT SOLUTION Dry ex: 0.50 POUND PER ACRE, 1 OUNCE PER ACRE

Activator 90 Loveland Products Inc. 0.25% percent solution (v/v)

Hi-Light Becker Underwood 025% percent solution (v/v)

Per BLM policy, Pesticide Application Records must be completed within 24 hours of pesticide application.

Associated Tracklog(s) File ID:

(ex: CraneSprings06052020_01)

CraneSprings06052020_01, CraneSprings06052020_02, CraneSprings06052020_03

Elko District Pesticide Use Proposal (PUP) Numbers:

NVE000-19-002-P =2,4-D

NVE000-19-003-P = Chlorsulfuron NVE000-19-004-P = Clopyralid NVE000-19-005-P =Dicamba NVE000-19-006-P =Glyphosate NVE000-18-001-P =Imazapic NVE000-19-007-P =Imazapyr NVE000-19-008-P =Metsulfuron methyl NVE000-19-009-P =Picloram NVE000-19-010-P =Sulfometuron NVE000-19-011-P =Triclopyr

NOTES/COMMENTS:

SPECIES INFORMATION

SPECIES COMMON NAME

(ex. Russian Knapweed)

SPECIES CODE

(ex: ACRE3)

PLANT PHENOLOGY

(circle one)

ESTIMATED PERCENT COVER

(1 -100%)

Scotch thistle ONAC

BARE GROUND – BOLT – BUD

DORMANT – FLOWER

MATURE – PRE-BUD ROSETTE

– SEED SET SCENESCENT –

VEGETATIVE

BARE GROUND – BOLT – BUD

DORMANT – FLOWER

MATURE – PRE-BUD ROSETTE

– SEED SET SCENESCENT –

VEGETATIVE

BARE GROUND – BOLT – BUD

DORMANT – FLOWER

MATURE – PRE-BUD ROSETTE

BARE GROUND – BOLT – BUD

DORMANT – FLOWER

MATURE – PRE-BUD ROSETTE

Weed Species Reference Information Common Name Code Common Name Code

African mustard BRTO Mayweed chamomile ANCO

African rue PEHA Mediterranean sage SAAE

Austrian fieldcress ROAU Medusahead TACA8

Black henbane HYNI Musk thistle CANU

Camelthorn ALMA Perennial pepperweed LELA2

Canada thistle CIAR4 Perennial sowthistle SOAR

Common crupina CRVU Poison-hemlock COMA

Common St. Johnwort HYPE Puncturevine TRTE

Crimson fountain grass PESE Purple loosestrife LYSA

Dalmation toadflax LIDA Purple starthistle CECA

Diffuse knapweed CEDI3 Rush skeletonweed CHJU

Dyer's woad ISTI Russian knapweed ACRE3

Eurasian watermilfoil MYSP Salt cedar TARA

Giant reed ARDO Scotch thistle ONAC

Giant salvinia SAMO Silverleaf nightshade SOEL

Goatsrue GAOF Spotted knapweed CEST8

Hoary cress CADR Squarrose knapweed CEVI

Horsenettle SOCA Sulfur cinquefoil PORE

Houndstongue CYOF Swainsonpea SPSA

Hydrilla HYVE Syrian bean caper ZYFA

Iberian starthistle CEIB Waterhemlock CIMA

Johnsongrass SOHA Yellow starthistle CESO

Leafy spurge EUES Yellow toadflax LIVU

Malta starthistle CEME Cheatgrass BRTE

Ventenata dubia VEDU Russian thistle SATR12