J-1503020-14.pdf

ATTACHMENT J-1503020-14

PEST MANAGEMENT OPERATIONS REPORT

New Pesticide Management Record (SAMPLE)

Directions:

1.

Select the installation and fill in the Office/Contractor, if applicable

2. Fill in a separate form for each pest management operation. For pesticide applications, the pounds of active ingredient (PAI) will be calculated automatically based on the data you enter.

Installation Name:

Department/Company:

Office/Contractor:

(optional)

Negative Report

Contract or In-House:

Application Date:

Inside or Outside:

Facility: Building # or Area

Operation:

Site:

Pest:

Applicator Name: Create Applicator List

5/17/2012 6:23:1

Save Defaults* Clear Defaults

ATTACHMENT J-1503020-14

PEST MANAGEMENT OPERATIONS REPORT (cont’d)

Pesticide Trade Name: - Select an installation to see the pesticide list

Pesticide Active Ingredient:

EPA Registration # or Other #:

Formulation:

Area Treated:

Quantity of Final Product Applied:

Final Concentration (%):

PAI*: Will be automatically calculated for the appropriate Operations*

Comments:

Additional Comments (Optional):

* Whatever is currently in the following fields will now be the default entry when the page is opened: Contract or In-

House; Application Date; Inside or Outside; Operation; Site. New: If you want the current date to continue to load while the other default values are loaded, save the Application Date as a blank.

Submit Record Delete Record