Exhibit 1.pdf
PDF 111 KB Posted
- Solicitation number
- 12444325Q0028
- Issued by
-
Department of Agriculture Forest Service
About this file
Exhibit 1 is a Treatment Reporting Form designed for documenting herbicide application details during invasive plant treatment operations in the Allegheny National Forest. The two-page form captures comprehensive information including contract and site-specific data such as weather conditions, treatment type, herbicide application method, and precise work item metrics.
The form requires detailed recording of treatment parameters, including area map labels, species treated, acres covered, start and stop times, water volume, herbicide and surfactant quantities, and calculated percentage solutions. The document includes conversion factors for area measurements and liquid volumes, enabling precise documentation of treatment activities. Contractors must complete sections on contract information, site conditions, treatment specifics, and provide signatures from both the contractor and the Contracting Officer's Representative (COR) or Government Technical Manager (GTM).
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment2.pdf | ||
| Amendment0001.pdf | ||
| Attachment1.pdf | ||
| Attachment 1.pdf | ||
| 12444325Q0028.pdf | ||
| Attachment 5.pdf | ||
| Attachment 2.pdf | ||
| Attachment 6.pdf | ||
| Attachment 4.pdf | ||
| Attachment 3.pdf |
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Text version
Exhibit 1: Treatment Reporting Form Project Area Name: _______________ Date:_________________ Contract Information Contract Number:
PA Certified Pesticide Applicator License Number
Contractor Name:
Expiration Date
Address: Contractor’s Personnel on Site Phone Office:
Phone Cell:
Site Information
Temperature0F
Rainfall anticipated within the next 4 hours (Yes/No)
Weather (Sun, Partly Cloudy, or Cloudy)
Rainfall within last 24 hours (Yes/No)
Wind Speed (MPH) Required for Herbicide Treatment Open area <10mph Closed Canopy <4 mph
Record mph at site
Slope %
Traffic Control Devices in Place (Yes/No) If no explain.
Notification Signs in Place (Yes/No) If no explain.
Treatment Information
Treatment Type Check all that apply
Low-volume foliar
High-Volume foliar
Cut-surface (stem)
Herbicide Application Method Herbicide Product Name:
Herbicide Common Name (active ingredient):
Surfactant Product Name:
Water Source Used
Comments/remarks (include information such as encounters with people, equipment issues, unusual conditions, etc.
Contractor’s Signature COR/GTM’s Signature: _______
Work Items – Note: record calculated numbers to two decimal places.
A B C D E F G
Area
– Map Label
NNIP
Species Treated
Amount Treated -acres
Start Time
Military:
HHMM
Stop Time
Military
HHMM
Volume of
Water (Gals)
Volume of Water (Ounces)
Glyphosate (Ounces)
Total Volume Ounces
(B+C+F)
Herbicide Percent Solution
_C_ X 100% D
Surfactant (Ounces)
Surfactant Percent Solution
_F_ X 100%
D
Conversion Factors
1gallon = 128 ounces 1quart = 32 ounces
Acres Area in
Square Feet Approximate Length
X Width 1 43,560 208.8’ x 208.8’
0.5 21,780 147.6’ x 147.6’
0.1 4,356 66’ x 66’
0.01 435 20.9’ x 20.9’
0.001 44 6.6’ x 6.6’
File details come from the government source that posted it. Updated .