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Section V. Appendix Sample Records and Forms 55 Premise Pesticide Use Record Rx Medication Diagnosis Signature: WD Withdrawal time Date Severity Rx 1 Rx 2 Comment WD Date: Date: Date: Date: Date:
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How to fill out premise pesticide use record

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01
To fill out a premise pesticide use record, you will first need to gather all relevant information regarding the pesticide application. This includes the date and time of application, the specific pesticide used, the target pest or problem, and the location where the pesticide was applied.
02
Begin by entering the date and time of the pesticide application in the designated section of the record. Be sure to accurately record the exact date and time to maintain the record's integrity.
03
Next, enter the specifics of the pesticide used. Include the brand or trade name, the active ingredients, and the EPA registration number of the pesticide. This information is crucial for tracking and monitoring pesticide usage.
04
Write down the name of the target pest or problem that the pesticide was intended to address. This could be anything from weeds to insects or fungal diseases. Providing this information helps in evaluating the effectiveness of the pesticide and identifying recurring pest issues.
05
Note the location where the pesticide was applied. Include the address or specific area such as a field, garden, or building. It is important to be as precise as possible to accurately track pesticide usage and potential environmental impacts.
06
Additionally, if there were any adverse effects or incidents associated with the pesticide application, make sure to document them in the record. This could include any spills, overspray, or other incidents that occurred during or after the application.
As for who needs a premise pesticide use record, it generally applies to individuals or organizations that are legally required to maintain records of their pesticide usage. This typically includes agricultural producers, commercial pesticide applicators, and even homeowners in certain jurisdictions. It is important to check the specific regulations in your area to determine if you are required to keep such records.
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A premise pesticide use record is a document that tracks the use of pesticides on a specific property or location.
Property owners or managers who apply pesticides on their property are required to file premise pesticide use records.
To fill out a premise pesticide use record, one must include details such as the date of application, type of pesticide used, amount applied, target pest, and any precautions taken.
The purpose of a premise pesticide use record is to track the application of pesticides on a property for safety and regulatory compliance purposes.
Information that must be reported on a premise pesticide use record includes the date of application, type of pesticide used, amount applied, target pest, and any precautions taken.
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