Statement_of_Work_Attachment_4_-_Pesticide_Application_Record.docx
DOCX document 33 KB Posted
- Attached to
- ASQ-SND AERIAL HERBICIDE APPLICATION Federal contract opportunity
- Solicitation number
- 140L0623R0038
About this file
This document is a pesticide application record template for the Bureau of Land Management Southern Nevada District. The template requires recording details of pesticide applications including chemical names and rates, equipment used, weather conditions, acres treated, distance to water, weed species and percent cover treated, and notes. It is to be filled out within 24 hours of each application and kept on record for 10 years.
The related federal contract opportunity is solicitation number 140L0623R0038 for aerial herbicide application services. The soliciting agency is the Department of the Interior Bureau of Land Management National Office. The opportunity type is a solicitation and services required include aerial application of herbicides.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Statement_of_Work_Attachment_1_-_DOI-BLM-NV-2010-2019-0053-EA.pdf | ||
| Statement_of_Work_Attachment_3_-_Vicinity_Map.zip | ZIP file | |
| Statement_of_Work_Attachment_2_-_Project_Area.pdf | ||
| Attachment_2-Wage_Determination.pdf | ||
| Sol_140L0623R0038.pdf | ||
| Statement_of_Work_Attachment_5_-_BLM_Appendix_B_Herbicide_Treatment_Standard_Operating_Procedures.pdf | ||
| Attachment_1-Price_Schedule.xlsx | XLSX spreadsheet |
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Text version
Pesticide Application Record (PAR) Southern Nevada District, Bureau of Land Management
Date:
Start:
Stop:
Location:
Legal Description:
PUPS # (see back for list):
Crew Lead:
Crew Members:
Recorder initials:
NEPA #:
Temp °F:
RH %:
Wind Direction:
Wind Max mph:
Wind Avg mph:
Time recorded:
Mix #
Chemical Trade Name I.e. Weedar 64, Tordon K, Tordon 22K Chemical Rate (oz/ac or % ) Adjuvant Trade Name I.e. Activator 90, Hi-light
| Chemical Rate (oz/ac or %) |
| Diluent |
(water or oil)
Chemical /Adjuvant Trade Name I.e. Weedar 64, Tordon K, Hi-light Chemical Common Name i.e. Picloram, 2,4-D Manufacturer (i.e Monsanto) EPA Number (i.e 42750-19) AE/A or AI/A amount (lb AE or AI/gal, See label) Equivalent Rate pounds AE or AI/ acre (See back for equation) Mix #(s) (from above)
Equipment type & Applicator wand or boom: Truck, utv backpack etc Calibrated Rate (gallons/acre) Mix # (from above) Total Mix Sprayed (Gallons) Acres Treated =Total Mix/ Calibrated rate Distance to Water 0-10,10-25,25-100, 100 + feet
| Weed Species Treated (scientific name, species code, or full common name) |
| Percent cover |
(multiples of 5)
| Life Stage/ phenology (bare ground, bolt, bud, dormant, flower, mature, pre-bud, rosette, seed set, seedling, senescent, vegetative) |
| Mix # (s) (from above) |
| Weed Species Treated (scientific name, species code, or full common name) |
| Percent cover |
(multiples of 5)
| Life Stage/ phenology (bare ground, bolt, bud, dormant, flower, mature, pre-bud, rosette, seed set, seedling, senescent, vegetative) |
| Mix # (s) |
(from above)
Notes:
*1 gallon = 4 quarts = 8 pints = 16 cups = 128 ounces *1 quart = 2 pints = 4 cups = 32 ounces *1 pint = 2 cups = 16 ounces *1 cup = 8 ounces *1 acre = 4046.9 meters squared= 43560 feet squared *1 mile = 5280 feet *1 meter = 3.28 feet oz to add to one gal= Herbicide rate (oz/ac) Calibrated Rate( gal/ac)
Multiply by gallons placed in tank to get oz to add to mix Equivalent Rate = Chemical Rate * AE/A amount 128 oz/gal Chemical Rate= oz/ac AE/A = lb/gal If given a percent then = Chemical rate * percent
PUP Numbers NVS000-23-001-P LVFO Uplands Herbicide Use PUP Numbers
-Please fill out daily and start a new sheet if you switch locations -When finished return sheet to weeds coordinator or crew lead -There must be a GPS/GIS record to go with each PAR -When in doubt ask questions and refer to cheat sheets to fill out -If you really can’t fill out one of the cells leave blank but write a bunch of notes and make sure that you take good GIS data
- Please write neatly and legibly these sheets will be referenced
- This form needs to be filled out within 24 hours of application and kept for 10 years!
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