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
The document is a Pesticide Applicator Record Keeping Form from the Texas Department of Agriculture. It requires the recording of details for pesticide applications, including the business/applicator name, application date and time, location, wind and temperature conditions, product information, application method, and licensure details for the applicator.
The related state and local contract opportunity is for herbicide application services to manage yaupon encroachment at the Camp Swift Training Center in Bastrop, Texas. The Texas Military Department is inviting bids for this work, with a mandatory site visit scheduled for July 30, 2024 and a proposal due date of August 15, 2024. An addendum will be released on August 8, 2024, and all questions must be submitted by August 5, 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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