Attachment_E_Pesticide_Application_Record.pdf

Pesticide Application Record (PAR) Southern Nevada District, Bureau of Land Management

Date:

Start:

Stop:

Location:

Legal Description:

PUPS # (see back for list):

Crew Lead:

Crew Members:

Recorder initials:

NEPA #:

Temp °F:

RH %:

Wind Direction:

Wind Max mph:

Wind Avg mph:

Time recorded:

Mix

Chemical Trade Name I.e. Weedar 64, Tordon K, Tordon 22K

Chemical Rate (oz/ac or % )

Adjuvant Trade Name I.e. Activator 90, Hi-light

Chemical Rate (oz/ac or %)

Diluent (water or oil)

Chemical /Adjuvant Trade Name I.e. Weedar 64, Tordon K, Hi-light

Chemical Common Name i.e. Picloram, 2,4-D

Manufacturer (i.e Monsanto)

EPA

Number (i.e 42750-19)

AE/A or AI/A amount (lb AE or AI/gal, See label)

Equivalent Rate pounds AE or AI/ acre (See back for equation)

Mix #(s) (from above)

Equipment type & Applicator wand or boom: Truck, utv backpack etc

Calibrated Rate (gallons/acre)

Mix # (from above)

Total Mix Sprayed (Gallons)

Acres Treated =Total Mix/ Calibrated rate

Distance to Water 0-10,10-25,25-100, 100 + feet

Weed Species Treated (scientific name, species code, or full common name)

Percent cover (m ultiples of 5)

Life Stage/ phenology (bare ground, bolt, bud, dormant, flower, mature, pre-bud, rosette, seed set, seedling, senescent, vegetative)

Mix # (s) (from above)

Weed Species Treated (scientific name, species code, or full common name)

Percent cover (m ultiples of 5)

Life Stage/ phenology (bare ground, bolt, bud, dormant, flower, mature, pre-bud, rosette, seed set, seedling, senescent, vegetative)

Mix # (s) (from above)

Notes:

*1 gallon = 4 quarts = 8 pints = 16 cups = 128 ounces *1 quart = 2 pints = 4 cups = 32 ounces

*1 pint = 2 cups = ounces *1 cup = 8 ounces

*1 acre = 4046.9 meters squared= 43560 feet squared *1 mile = 5280 feet *1 meter = 3.28 feet oz to add to one gal= Herbicide rate (oz/ac) Calibrated Rate( gal/ac)

Multiply by gallons placed in tank to get oz to add to mix

Equivalent Rate = Chemical Rate * AE/A amount 128 oz/gal Chemical Rate= oz/ac AE/A = lb/gal If given a percent then = Chemical rate * percent

PUP Numbers NVS000-23-006-P Trout Canyon Substation

PUP Numbers

-Please fill out daily and start a new sheet if you switch locations -When finished return sheet to weeds coordinator or crew lead -There must be a GPS/GIS record to go with each PAR -When in doubt ask questions and refer to cheat sheets to fill out -If you really can’t fill out one of the cells leave blank but write a bunch of notes and make sure that you take good GIS data

- Please write neatly and legibly these sheets will be referenced

- This form needs to be filled out within 24 hours of application and kept for 10 years!