Agricultural Chemical Record [Suitable for frequent application to the same areas such as owners and employees of farming – operations] Name & Address of person for whom the spraying was carried out [land owner or lessee: Operators Details Operator 1 - Name: Address: Spray Applicator Licence No. (If applicable) : Authorisation for S7 or Restricted Product (if applicable): Operator 2 - Name: Address: Spray Applicator Licence No. (If applicable) : Authorisation for S7 or Restricted Product (if applicable) Operator 3 - Name: Address: Applicator Licence No. (If applicable) : Authorisation for S7 or Restricted Product (if applicable) Operator 4 - Name: Address: Spray Applicator Licence No. (If applicable) : Authorisation for S7 or Restricted Product (if applicable) Certification by Operator I hereby certify that this spray diary contains a true and accurate record of my agricultural spraying activities on the properties described in this diary. Signed : Operator1: Date: / / Signed : Operator 2: Date: / / Signed : Operator 3: Date / / Signed : Operator 4: Date / / The information in this diary must be retained for 2 years after the date of spray application as prescribed in the Agricultural and Veterinary Control of Use Regulations, 2004, regulation 9.
Agricultural Chemical Record [Suitable for frequent application to the same areas – such as owners and employees of farming operations] Name & Address of person for whom the spraying was carried out [land owner or lessee: Operators Details Operator 1 - Name: Address: Spray Applicator Licence No. (If applicable) : Authorisation for S7 or Restricted Product (if applicable): Operator 2 - Name: Address: Spray Applicator Licence No. (If applicable) : Authorisation for S7 or Restricted Product (if applicable) Operator 3 - Name: Address: Applicator Licence No. (If applicable) : Authorisation for S7 or Restricted Product (if applicable) Operator 4 - Name: Address: Spray Applicator Licence No. (If applicable) : Authorisation for S7 or Restricted Product (if applicable) Certification by Operator I hereby certify that this spray diary contains a true and accurate record of my agricultural spraying activities on the properties described in this diary. Signed : Operator1: Date: / / Signed : Operator 2: Date: / / Signed : Operator 3: Date / / Signed : Operator 4: Date / / The information in this diary must be retained for 2 years after the date of spray application as prescribed in the Agricultural and Veterinary Control of Use Regulations, 2004, regulation 9.
agricultural-chemical-spray-record-v5.docx