W911SA-17-Q-3000_Attachment_7_Grounds_Weed_Control_Form.docx
DOCX document 26 KB Posted
- Attached to
- Grounds Maintenance; Multiple Sites in Iowa Federal contract opportunity
- Solicitation number
- W911SA-17-Q-3000
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W911SA-17-Q-3000_Attachment_7_Grounds_Weed_Control_Form
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| W911SA-17-Q-3000_Attachment_1_Price_Schedule.xlsx | XLSX spreadsheet | |
| W911SA-17-Q-3000_Attachment_8_Grounds_Service_Ticket.docx | DOCX document | |
| W911SA-17-Q-3000_Solicitation.pdf | ||
| W911SA-17-Q-3000_Attachment_10_Wage_Determinations.docx | DOCX document | |
| W911SA-17-Q-3000_Attachment_3_IA006_Drawing.docx | DOCX document |
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Text version
88th RSC
WEED CONTROL RECORD FORM
Version 1.2; 05 Apr 2017 A separate form shall be filled out for each operation.
Please print for number 1-8.
1. Date of Application: _________________________
2. Facility Name: ____________________________
3. Type of Application: ________________________________________ (e.g., power spray, manual application etc.)
4. Site Description: ______________________________________ (e.g. lawn, unimproved ground, fence line, parking lot cracks, etc.)
5. Size of Area Treated: _________________________________ [Include unit, SF (square feet), LF (linear feet), AC (acre), CF (cubic feet)]
6. Applicator’s Name: ___________________________________
7. Herbicide Used:
7a. Herbicide Trade Name: ___________________________________
7b. Herbicide Active Ingredient: ________________________________________
7c. EPA or State Reg # : ________________________________
7d. Formulation: _____________________________________
7d. Quantity of herbicide applied ____________________________ [(include unit, FL (fluid ounce), GA (gallon), ML (milliliter), LT (liter), LB (pound), DR (dry ounce), GR (gram), KG (kilogram)]
7e. Final Concentration Applied (%): _______________________________
8. Additional Comments: (survey results, wind conditions, sanitation deficiencies, etc.)
9. Signature of Applicator: ___________________________________
10. Certification # of Applicator: _______________________________
11. (PWS #5.3.5) Copy of this form attached to invoice in iRAPT on (date): ___________________ Version 1.2 05 APR 2017
File details come from the government source that posted it. Updated .