Dip Vat Blank Application Record 2021.docx

UNITED STATES DEPARTMENT OF THE INTERIOR

BUREAU OF LAND MANAGEMENT

TWIN FALLS DISTRICT

PESTICIDE APPLICATION RECORD

Load of _____

1. Project Name: DIP VAT

2. PUP Originator: Anthony Owens

3. Applicator:

4. GPS File Name (if applicable):

5. Date of Application: Time of Application:

6. Wind Velocity: Wind Direction: Temperature:

7. General Location:

8. Equipment Used: Truck UTV Backpack Mechanical

9. Actual Area Treated: Acres

13. Pest (s) Involved:

14. Pesticide Used:

a. Company or Manufactures Name:

b. Trade Name:

c. Type of Formulation: Liquid X Granular WP

d. Rate of Application: /quart acre /total gallons used

e. Rate of A.I. Ingredients: ________ / # A.I. acre __________ / total # A.I.

f. PUP Number: IDT00-18-001-P

g. EPA Number:

a. Company or Manufactures Name:

b. Trade Name:

c. Type of Formulation: Liquid X Granular WP

d. Rate of Application: /quart acre /total gallons used

e. Rate of A.I. Ingredients: ________ / # A.I. acre __________/ total # A.I.

f. PUP Number: IDT00-18-001-P

g. EPA Number:

15. Adjuvant(s) Used:

a. Trade Name: Alligare 90

b. Total Amount Used:

16. Water Used: /gallons acre /total gallons used

17. Comments: _________________________________________________________________