PestControlApplicationRecord.pdf

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PEST CONTROL APPLICATION RECORD

ATTENTION: This record must be completed the same day as the application, and a separate record completed for each pest control category or change in formulation. It must be forwarded electronically within 7 days to the assigned Corps of Engineers Pest Manager.

Page of Page of

1. Pesticide Application Sponsor

2. Licensed Pest Applicator Alternate Pest Applicator (if applicable) Chemical Control Trade Name Active Ingredient (AI) Pounds of AI Pesticide Classification EPA Registration No.

State Permit Required State Permit No.

4. Pest Management Application Date Start Time (HHMM) Stop Time (HHMM) Acres Wind Direction Wind Speed (mph) Temperature (F) Application Method Platform License Plate Medium

5. GPS Coordinates (WGS84, Decimal Degrees) of Application Longitude (nnn.nnnnn) Latitude (nn.nnnnn) Application Radius (ft)

6. Target Species Pest Category Pest Name Number of Pests Treated

INSTRUCTIONS

Pest Control Application Record Notes:

- Selecting 'Other' in any field requires supplemental information in the Comments field.

- The 'Reset all but Applicator Data' button may be used to clear the record while preserving applicator information.

- The 'Email Data' button may be used to return record data to the assigned Corps of Engineers Pest Manager.

1. Pesticide Application Sponsor: Include contact information for the entity sponsoring the application.

2. Licensed Pest Applicator: Include contact and license information for the individual performing the application.

Alternate Pest Applicator (if applicable): Enter the alternate licensed pest applicator's information.

3. Pest Control Category: Select a general category of pest control. The form will present fields relevant to the chosen category. Changing categories requires an additional form.

Chemical Control (if applicable): If applying a mixture of chemicals, use the 'Add Row' and 'Delete Row' buttons as required to describe all chemicals in the mixture. Changing mixtures requires an additional form. The trade name is found on the pesticide label including adjuvants (buffer, spreader, sticker, surfactant) etc.). EPA Registration Number: If the material is being applied under a federal experimental use permit and no EPA Reg. No. exists, list the federal experimental use permit number.

Biological Control (if applicable): select the biological control used.

Mechanical Control (if applicable): select the mechanical control used.

4. Pest Management Application: Indicate the direction from which the wind is blowing. Measure wind velocity in mph. If the wind varies in direction and velocity during the application, indicate the prevailing conditions. Wind readings shall be obtained in close proximity to the application site. Indicate average temperature in degrees Fahrenheit. Temperature readings shall be obtained in close proximity to the application site.

5. GPS Coordinates (WGS84, Decimal Degrees) of Application: Taken from hand-held GPS unit at the time of application. The location of an application is collected as a point, requiring a single latitude-longitude pair at the center of the application. Enter position information to at least the forth decimal place (46.0001). For each application, estimate a radius to the edge of the treated area. See graphic below for examples.

6. Target Species: Describe the pest that is being controlled.

Pest Control Application Record Proponent: Operations Division November, 2012 Previous edition is obsolete.

8.2.1.4029.1.523496.503679 NWW_pest_mgmt_reports@usace.army.mil USACE NWW District Pest Control Application Record