W911SA-19-Q-3041_Attachment_1_Grounds_Weed_Control_Form.docx

DOCX document 28 KB Posted

Attached to
Grounds Services, Michigan Multisite, MI043 Federal contract opportunity
Solicitation number
W911SA-19-Q-3041
Issued by
Department of the Army Materiel Command Mission and Installation Contracting Command Fort McCoy

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W911SA-19-Q-3041 Attachment 1 Grounds Weed Control Form

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W911SA-19-Q-3041_Released_Amendment_0005_SF30.docx DOCX document
W911SA-19-Q-3041_Released_Amendment_0002_SF30.docx DOCX document
W911SA-19-Q-3041_Attachment_3_AT_OPSEC.pdf PDF
W911SA-19-Q-3041_Released_Amendment_0003_SF30.docx DOCX document
W911SA-19-Q-3041_Attachment_4_Grounds_Service_Ticket.docx DOCX document
W911SA-19-Q-3041_Released_Amendment_0001_SF30.docx DOCX document
W911SA-19-Q-3041_Released_Amendment_0004_SF30.docx DOCX document
W911SA-19-Q-3041_Attachment_5_Price_Schedule_Revised_3-27-19.xlsx XLSX spreadsheet
W911SA-19-Q-3041_Solicitation_SF1449_comp_8a.docx DOCX document
W911SA-19-Q-3041_Attachment_6_SUS_Trifold.pdf PDF
W911SA-19-Q-3041_Attachment_2_Drawings.pdf PDF
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Text version

88th RD

WEED CONTROL RECORD FORM

Version 1.4; 14 May 2018 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): ___________________

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