Attachment4.pdf
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- Solicitation number
- W912ES-10-R-0023
About this file
Attachment 4 Post Application Form
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Other files
| File | Type | Posted |
|---|---|---|
| W912ES10R0023 Amendment 1.doc | DOC document | |
| W912ES10R0023.pdf | ||
| Attachment 2 Designated Management Prescription Maps.pdf | ||
| Attachment 1 Vicinity Map.pdf | ||
| Attachment3.pdf | ||
| Attachment 5 Submittal Register.pdf |
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ATTACHMENT 4
POST-APPLICATION DOCUMENTATION FORM
ST PAUL DISTRICT DATE: _____________________
U.S. ARMY CORPS OF ENGINEERS Address:___________________________ PEST CONTROL PROGRAM City:______________________________ POST-APPLICATION DOCUMENTATION FORM Phone:_____________________________
CONTRACTOR: ___________________________ APPLICATOR:_____________________________
Addr: ____________________________________ Addr: _____________________________________ City: ____________________________________ City: _____________________________________ Phone: ___________________________________ Phone: _____________________________________
TARGET PEST: _________________________________________________________
DATE OF TIME OF AIR RELATIVE WIND DIRECTION ACREAGE
APPLICATION DAY TEMP HUMIDITY CLOUD COVER AND SPEED TREATED
DESCRIPTION OF TREATED AREA: _____________________________________________________
PESTICIDE (TRADE NAME): ___________________________________________________________
FORM APPLIED: ______________________________________________________________________
ACTIVE INGREDIENTS: _______________________________________________________________
EPA REGISTRATION: ______________________ EPA CLASSIFICATION: _____________________
HOW THE PESTICIDE WAS MIXED: _____________________________________________________
APPLICATION RATE (TOTAL): ______________________ APPLICATION RATE [ACTIVE
INGREDIENT(S)]: _____________________________________________________________________
APPLICATION EQUIPMENT USED: _____________________________________________________
AMOUNT APPLIED: ___________________________________________________________________
DISPOSAL INFORMATION DISPOSAL DATE: ___________
METHOD: ____________________________________________________________________________
LOCATION: __________________________________________________________________________
ADDITIONAL REMARKS: ______________________________________________________________
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