Pesticide_Application_Record_-_Sample_-_For_Viewing_Purposes_Only.pdf
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- Solicitation number
- MO27-13
- Issued by
- Ada County, Idaho
About this file
The Ada County Highway District (ACHD) in Idaho is soliciting competitive proposals for herbicide application services through the 2027 Roadside, Sidewalk, and Basin Herbicide Application Services contract opportunity. The selected firm shall provide initial and follow-up treatments to control noxious and nuisance vegetation along roadsides, sidewalks, stormwater basin perimeters, upland areas, designated basin side slopes, access roads, and other ACHD-authorized locations within ACHD-owned or maintained public rights-of-way and stormwater facilities. The firm must furnish all qualified personnel, equipment, herbicides, traffic control, and documentation necessary to perform the work in compliance with all applicable federal, state, and local regulations, safety, and environmental standards. A voluntary pre-submission meeting and proposal workshop is scheduled for November 10, 2026, from 10:00 a.m. to 11:00 a.m. at ACHD Headquarters, 5800 N. Meeker Avenue, Boise, Idaho 83713. Attendance is voluntary and is not a condition of proposal responsiveness.
Proposals will be evaluated based on established criteria including cost, qualifications, experience, and the respondent's demonstrated ability to safely, lawfully, and effectively perform the required herbicide application services in accordance with the RFP Scope of Work and Specifications. The file provided is a sample Pesticide Application Record form from the Idaho Vegetation Division that must be completed on the same day as application and retained for three years; this form illustrates the documentation requirements contractors must maintain for herbicide applications, including details on application date, applicator information, pesticide products used, application location, environmental conditions, and application methods.
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Text version
Vegetation Division
440 N. Cloverdale Road Boise, Idaho 83713 208-387-6358
Pesticide Application Record This form must be completed the same day as the application and it must be retained for 3 years.
1. Date of Application -Year: ________ Month: _________ Day: _________ Start Time: ________ Stop Time: ________
2. Name of Person for whom the pesticide was applied: ________________________________________
Firm Name (if applicable): _____________________________________________________________
Streeet Address: _____________________________ City: ___________ State: ___ Zip: __________
3. Licensed Applicator’s Name (if different from #2 above): ___________________ Lic. Number _______
Firm Name (if applicable): ___________________________ Phone Number: ____________________
Street Address: ____________________________ City: _________________ State: ____ Zip: _____
4. Name of person(s) who applied the pesticide (if different from #3 above): _______________________
________________________________ License Number(s) (if applicable): ______________________
5. Crop or Type of Site: _________________________________________________________________
6. Total Area Treated (acre. Square feet, etc.): _______________________________________________
7. Was this application made as a result of a permit? No Yes - If yes, give Permit Number: ___________
8. Pesticide Information (list all information for each pesticide, including adjuvants (buffer, surfactant, etc.)
in the tank mix):
a) Full
Product
Name
b) EPA
Registration
Number
c) Total Amount of Pesticide
Applied in Area
Treated
d) Pesticide
Applied/Acre (or other measure)
e. Concentration
Applied
9. Address or exact location of application (if the application is made to one acre or more of agricultural land, the field location must be shown on the map on page four of this form):
10. Wind direction and estimated velocity (mph) during the application: ______________________________
11. Temperature (F*) during the application ____________________________________________________
12. Apparatus license plate number (if applicable): ______________________________________________
13. Application Method/Type (circle one): Air Ground Chemigation
14. Depth of Chemigation Application: ________________________________________________________
15. Other information: _____________________________________________________________________
Location of Application
If the application covers more than one township or range, please indicate the township & range for the top left section of the map only.
Township: _____________________N
Range: _______________________ E W (please indicate)
Section(s): ____________________
Block: ________________________ Farm Unit: _________________________________
Or GPS: _________________________________________________________________
County: _________________________________________________________________
PLEASE NOTE: The map is divided into 4 section with each section divided into quarter-quarter sections.
Please complete it by marking the appropriate section number(s) on the map and indicate as accurately as possible the location of the area treated.
Section: ________________ Section: ________________
Other Information:
File details come from the government source that posted it. Updated .