Pesticide Application Record Template.docx
DOCX document 37 KB Posted
- Attached to
- Phase II Overland Pass Habitat Improvement Project FY24 Invasive Weeds Survey/Inventory/Treatment Contract
- Solicitation number
- FY24004
- Issued by
-
Department of Agriculture Forest Service
About this file
This document is a Pesticide Application Record (PAR) template for a federal contract opportunity. The key details are:
The contract opportunity is for the Phase II Overland Pass Habitat Improvement Project FY24 Invasive Weeds Survey/Inventory/Treatment Contract. The Forest Service requires services to survey, inventory, treat, and monitor invasive weed species infestations across approximately 2,758 acres. Known weed species include leafy spurge, white top, spotted knapweed, Russian knapweed, Scotch thistle, bull thistle, musk thistle, Canada thistle, and cheatgrass. The contractor must provide all labor, supervision, equipment, supplies, transportation, services, permits, and licenses necessary to complete the required work, except for what is specified as furnished by the government. Bids are due by 3:00 PM on 07/31/2024 via email to the Contract Specialist.
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Other files
| File | Type | Posted |
|---|---|---|
| FY24 Weeds Contract Unit 5.pdf | ||
| FY24 Weeds Contract Units 1 and 2.pdf | ||
| FY 24 Weeds Contract Unit 4.pdf | ||
| 1996weedEA.pdf | ||
| FY24 Overland Weeds Contract SOW.doc | DOC document | |
| FY24 Weeds Contract Unit 3.pdf | ||
| HTF Pesticide and active ingredient_updated 2020.docx | DOCX document | |
| FY24 Overland Weeds Contract SOI.docx | DOCX document | |
| Overland WorkPlan.pdf | ||
| FY24 Overlan Weeds Units 1-5.pdf | ||
| FY 24 Weeds Contract IGE.xlsx | XLSX spreadsheet |
Show all 11
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Text version
| GROUND - Pesticide Application Record (PAR) | Contract or Agreement Number:________________________ |
| Mountain City-Ruby Mountains-Jarbidge RD | FS Project Name: __________________________________ |
| 660 S 12th Street Suite 108, Elko, NV 89801 | Company Name: ______________________________________ |
| TREATMENT INFORMATION |
Date (ex: 6/1/2014) BLM PUP # (Refer to page 2 for a list)
Weather Reading time (START):
| Temperature °F: |
| RH %: |
| Wind Direction: |
| Wind Max mph: |
| Wind Avg mph: |
Weather Reading time (STOP):
| Temperature °F: |
| RH %: |
| Wind Direction: |
| Wind Max mph: |
| Wind Avg mph: |
Licensed Applicator Name, License Number AND Crew Members
Mix Diluent (circle one)
WATER
OIL
NONE
Equipment Used (circle one) TRUCK – ATV – UTV - BACKPACK – AIRPLANE - HELICOPTER – HANDHELD SPRAYER – WICK/WIPER – MOWER
TRACTOR – HORSEBACK SPRAYER
Sprayer Calibration Rate (ex: 2 GALLONS/ACRE) (circle appropriate Rate)
GALLONS/ACRE
POUNDS/ACRE
Distance to Water (circle one)
0 TO 10 FEET
10 TO 25 FEET
25 TO 100 FEET
GREATER THAN 100 FEET
Delivery Method (circle one)
| AERIAL – GROUND |
| Spray Pattern |
(circle one)
BROADCAST – SPOT
Mix Amount Applied on Site (ex: 2 GALLONS)
Total Acres Treated: (ex: 40 ACRES)
Swath Width of Equipment (Broadcast Only) (ex: 50 FEET; NA for SPOT)
FOR LINEAR FEATURES ONLY (i.e. road or stream)
Buffer Width
| Buffer Width Units |
| FEET |
| Buffer Direction |
(circle one)
LEFT - CENTER - RIGHT
Note on Buffer Direction: left or right will buffer in only one direction, while center will buffer both sides based on the width and units provided. For instance a right buffer of 10 feet will buffer 10 feet on the right only while a center buffer of 10 feet will buffer both sides of the centerline (total buffer is 20 feet)
CHEMICAL BRAND(s) APPLIED - In formulated product units
| CHEMICAL TRADE NAME (ex: Roundup Pro, Overdrive) |
| MANUFACTURER |
(ex: MONSANTO, BASF)
EPA REG #
(ex: 524-475, 7969-150)
CHEMICAL
COMMON NAME
(ex: Glyphosate, Dicamba + Diflufenzopyr)
RATE OF APPLICATION
Liquid ex: 2 QUARTS PER ACRE, , 8 FLUID OUNCES PER ACRE, 1 PERCENT SOLUTION Dry ex: 0.50 POUND PER ACRE, 1 OUNCE PER ACRE
ADJUVANTS BRAND(s) APPLIED - In formulated product units
| ADJUVANT BRAND NAME (ex: DYNE_AMIC) |
| MANUFACTURER |
(ex: HELENA CHEMICAL)
RATE OF APPLICATION
Liquid ex: 2 QUARTS PER ACRE, , 8 FLUID OUNCES PER ACRE, 1 PERCENT SOLUTION Dry ex: 0.50 POUND PER ACRE, 1 OUNCE PER ACRE
Per BLM policy, Pesticide Application Records must be completed within 24 hours of pesticide application and are kept for a minimum of 10 years.
Associated Tracklog(s) File ID: (ex: CraneSprings06052020_01)
Elko District Pesticide Use Proposal (PUP) Numbers:
NVE000-19-002-P =2,4-D
NVE000-19-003-P = Chlorsulfuron NVE000-19-004-P = Clopyralid NVE000-19-005-P =Dicamba NVE000-19-006-P =Glyphosate NVE000-18-001-P =Imazapic NVE000-19-007-P =Imazapyr NVE000-19-008-P =Metsulfuron methyl NVE000-19-009-P =Picloram NVE000-19-010-P =Sulfometuron NVE000-19-011-P =Triclopyr
NOTES/COMMENTS:
(i.e. Rain event? If so, time of rain event? Duration? Was it a wetting rain? When did you stop your application?)
SPECIES INFORMATION
SPECIES COMMON NAME
(ex. Russian Knapweed)
SPECIES CODE
(ex: ACRE3)
PLANT PHENOLOGY
(circle one)
ESTIMATED PERCENT COVER
(1 -100%)
BARE GROUND – BOLT – BUD DORMANT – FLOWER MATURE – PRE-BUD ROSETTE – SEED SET SCENESCENT – VEGETATIVE
BARE GROUND – BOLT – BUD DORMANT – FLOWER MATURE – PRE-BUD ROSETTE – SEED SET SCENESCENT – VEGETATIVE
BARE GROUND – BOLT – BUD DORMANT – FLOWER MATURE – PRE-BUD ROSETTE – SEED SET SCENESCENT – VEGETATIVE
BARE GROUND – BOLT – BUD DORMANT – FLOWER MATURE – PRE-BUD ROSETTE – SEED SET SCENESCENT – VEGETATIVE
Weed Species Reference Information
| Common Name |
| Code |
| Common Name |
| Code |
| African mustard |
| BRTO |
| Mayweed chamomile |
| ANCO |
| African rue |
| PEHA |
| Mediterranean sage |
| SAAE |
| Austrian fieldcress |
| ROAU |
| Medusahead |
| TACA8 |
| Black henbane |
| HYNI |
| Musk thistle |
| CANU |
| Camelthorn |
| ALMA |
| Perennial pepperweed |
| LELA2 |
| Canada thistle |
| CIAR4 |
| Perennial sowthistle |
| SOAR |
| Common crupina |
| CRVU |
| Poison-hemlock |
| COMA |
| Common St. Johnwort |
| HYPE |
| Puncturevine |
| TRTE |
| Crimson fountain grass |
| PESE |
| Purple loosestrife |
| LYSA |
| Dalmation toadflax |
| LIDA |
| Purple starthistle |
| CECA |
| Diffuse knapweed |
| CEDI3 |
| Rush skeletonweed |
| CHJU |
| Dyer's woad |
| ISTI |
| Russian knapweed |
| ACRE3 |
| Eurasian watermilfoil |
| MYSP |
| Salt cedar |
| TARA |
| Giant reed |
| ARDO |
| Scotch thistle |
| ONAC |
| Giant salvinia |
| SAMO |
| Silverleaf nightshade |
| SOEL |
| Goatsrue |
| GAOF |
| Spotted knapweed |
| CEST8 |
| Hoary cress |
| CADR |
| Squarrose knapweed |
| CEVI |
| Horsenettle |
| SOCA |
| Sulfur cinquefoil |
| PORE |
| Houndstongue |
| CYOF |
| Swainsonpea |
| SPSA |
| Hydrilla |
| HYVE |
| Syrian bean caper |
| ZYFA |
| Iberian starthistle |
| CEIB |
| Waterhemlock |
| CIMA |
| Johnsongrass |
| SOHA |
| Yellow starthistle |
| CESO |
| Leafy spurge |
| EUES |
| Yellow toadflax |
| LIVU |
| Malta starthistle |
| CEME |
| Cheatgrass |
| BRTE |
| Ventenata dubia |
| VEDU |
| Russian thistle |
| SATR12 |
Per BLM policy, Pesticide Application Records must be completed within 24 hours of pesticide application.
File details come from the government source that posted it. Updated .