ESBD_368510_1721250695646_Appendix A Pesticide Applicator Record keeping Form.pdf
PDF 161 KB Posted
- Attached to
- Camp Swift Herbicide Application Services
- Solicitation number
- TMD24-CFMO-0036207
- Issued by
- Bastrop County, Texas
About this file
This document is a pesticide applicator record form from the Texas Department of Agriculture. It outlines the required information to be recorded when applying pesticides, including the application date, location, weather conditions, product details, application method, and applicator information.
The related state and local contract opportunity is for herbicide application services at Camp Swift Training Center in Bastrop, Texas. The Texas Military Department (TMD) is soliciting bids for these services to manage yaupon encroachment in environmentally sensitive areas. The contract requires vendors to attend one of two mandatory site visits on July 30, 2024, and submit any questions by August 5, 2024. An addendum will be released on August 8, 2024, and proposals are due by 11:00 AM CST on August 15, 2024.
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Text version
Texas Department of Agriculture Pesticide Applicator Record
Business/Applicator Name ____________________________________ Address ______________________________________________________________________
Application
Date
Time Started Name of the person for whom the application was made
Location of Land Treated Site Treated
Wind
Direction
Velocity
Air
Temp
Product Trade Name EPA Registration
Number
Target Pest Rate of Product Per
Unit
Method or Type of Equipment
Used To Make Application
FAA “N” Number for Aerial
Application Equipment:
Is Application Applied in Regulated County: □ Yes □ No Regulated Herbicide Permit Number:
Licensed Applicator’s Name and License Number Non-licensed Applicator’s Name Working
Under Licensee
Total Acres or Volume of Area Treated
Total Volume of Spray Mix, Dust, Granules or Other Materials Applied Per Unit
Documentation used to verify training of non-licensed applicator (Mark Applicable Box)
□ Direct Supervisor Affidavit □WPS Handler Card □Signed & Dated Label
Application
Date
Time Started Name of the person for whom the application was made
Location of Land Treated Site Treated
Direction
Velocity
Air
Temp
Product Trade Name EPA Registration
Number
Target Pest Rate of Product Per
Unit
Method or Type of Equipment
Used To Make Application
FAA “N” Number for Aerial
Application Equipment:
Is Application Applied in Regulated County: □ Yes □No Regulated Herbicide Permit Number:
Licensed Applicator’s Name and License Number Non-licensed Applicator’s Name Working
Under Licensee
Total Acres or Volume of Area Treated
Total Volume of Spray Mix, Dust, Granules or Other Materials Applied Per Unit
Documentation used to verify training of non-licensed applicator (Mark Applicable Box)
□ Direct Supervisor Affidavit □WPS Handler Card □Signed & Dated Label
TDA Q527
7/15
COMMISSIONER SID MILLER
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