Pesticide Use Record Business Name ________________________ Address ___________________________________ Application Time Started Name of the person who Location of Land Treated Site Treated At time of treatment Date applied treatment Wind Wind Air Temp Direction Velocity Product Trade Name EPA Registration # Target Pest Rate of Product Equipment ID # Spray Permit # Per Unit Licensed Applicator’s Name & License # Unlicensed Applicator’s Name (If Acres or Total Volume of Spray Mix, Dust, applicable) Volume of Acres Granules or other Materials Applied Per Treated Unit Additional Information
Pesticide Use Record Business Name ________________________ Address ___________________________________ Application Date Time Started Name of the person who applied treatment Location of Land Treated Site Treated At time of treatment Wind Direction Wind Velocity Air Temp Product Trade Name EPA Registration # Target Pest Rate of Product Per Unit Equipment ID # Spray Permit # Licensed Applicator’s Name & License # Unlicensed Applicator’s Name (If applicable) Acres or Volume of Acres Treated Total Volume of Spray Mix, Dust, Granules or other Materials Applied Per Unit Additional Information
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