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PESTICIDE APPLICATION RECORD NORTH DAKOTA DEPARTMENT OF AGRICULTURE PESTICIDE AND FERTILIZER DIVISION SON 53456 (2-2013) Name Date Address City State ZIP Code Equipment Used PRODUCT EPA NUMBER PPE

How to fill out spray record sheet form

1. To fill out a printable chemical spray record, begin by gathering all necessary information such as the date and time of the spray, the name of the chemical being used, and the location where the spray is being applied.
2. Next, carefully review the instructions on the printable chemical spray record form to ensure you understand how to accurately complete each section. This may include providing details about the application method, the target area, and the required personal protective equipment.
3. Use legible handwriting or type the information into the appropriate fields on the printable form. Double-check your entries for accuracy and completeness to avoid any errors or omissions.
4. If there are any specific guidelines or regulations in place, such as those related to environmental or occupational safety, make sure to adhere to them and include any required documentation or certification.
5. After filling out the printable chemical spray record, store it in a safe and accessible location for future reference. It may be necessary to retain these records for a certain period of time, depending on local laws and regulations.

Who needs printable chemical spray record?

1. Agricultural workers who are spraying pesticides or other chemicals on crops.
2. Pest control professionals who are applying insecticides or herbicides in residential or commercial settings.
3. Industrial workers who are using chemical sprays for cleaning or disinfection purposes.
4. Landscapers or groundskeepers who are applying fertilizers or weed control products.
5. Any individual who is responsible for the safe and regulated use of chemical sprays in their respective field or industry.

Video instructions and help with filling out and completing spray record sheet

Instructions and Help about chemical record sheet form

This video will show you how to clean your knapsack sprayer after spraying. You will need: your pesticide label, your knapsack sprayer and its handbook, clean water, a mixing tray or a square meter of plastic sheet, a spill kit, detergent, a paper towel and plastic bag, a small container, record sheets and your Personal protective equipment (PPE). Unless the pesticide label directs otherwise, wear the same PPE for cleaning your knapsack sprayer as you do for applying the pesticide. You will also need a safe area for cleaning. Refer to your label for any advice on selecting an area that is away from animals, children and surface water such as streams and ponds, and is not near any drinking water sources and other sensitive areas. It is important to wear PPE because the sprayer is likely to be contaminated on the outside as well as the inside and these deposits can easily contaminate you and your work place. Add about a liter of clean water to the sprayer tank. If the label requires you to use detergent, add it to the water now. Replace the lid and shake and then carefully invert the sprayer. Remove the nozzle and its filter and soak both in a container of water. Remove the lid and tank basket filter. Direct the end of the lance into the tank and pump the lever to circulate the spray solution. Without the nozzle in place — you can pump very easily and will get a very rapid flow through the system which washes out the pump and all the hoses. Check that the lid, filter basket, nozzle and its filter are clean before now refitting. Where the detergent used will not damage plants, spray the rinsing water onto a sprayed part of the treatment area. Using only water, rinse the tank twice more in the same way. The inside of the sprayer should be clean. Next wash the outside of the sprayer over your plastic sheet or tray and dispose of the rinsing water safely. As well as triple rinsing your sprayer it is important to triple rinse any emptied pesticide containers. It is always best to do this at the time of mixing, so that the water used to clean the empty containers can be included as part of the water volume and used to form the spray solution. Have a look at the video on mixing pesticides for a fuller explanation. Even though you have washed the containers, replace the caps securely and store the containers safely until you can dispose of them. When mixing and spraying your last tankful, you will have mixed a little less pesticide than you needed and left a small area sprayed. This means that you will have no leftover spray to dispose of, and you can also spray your previously sprayed area with the water that you used to clean your sprayer. If your calculations haven’t quite worked out as you’d PLA, and you still have cleaning water remaining, identify a cropped weedy area on which you can safely spray, thus disposing any excess spray solution and tank rinsing Never pour these rinsing down drains or at any single point. © 2015, Tangent. All rights...

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Who is required to file printable chemical spray record?

The applicator or any other person responsible for using a pesticide must file a printable chemical spray record. Depending on the state, this may be required after each application or at the end of each season.

What is the purpose of printable chemical spray record?

Printable chemical spray records are used to document the application of chemical sprays in a given area. These records provide a record of the date, time, and type of chemical used, as well as the amount and target area of the chemical application. This information is important for tracking the effectiveness of chemical treatments and for ensuring compliance with local and state laws regulating the use of chemical sprays.

What is printable chemical spray record?

A printable chemical spray record refers to a document or form that is designed to be printed and used for recording information about the use or discharge of a chemical spray. It typically includes fields or sections where relevant details can be recorded, such as the date and time of use, the type and concentration of the sprayed chemical, location where it was used, any safety precautions taken, and the name or signature of the person responsible for the application. This record can be helpful for tracking and documenting the use of chemical sprays for various purposes such as pest control, cleaning, or agriculture.

How to fill out printable chemical spray record?

Filling out a printable chemical spray record can help you keep track of the use of chemical sprays for safety and regulatory compliance. Here are the steps to fill out the form: 1. Gather the necessary information: Before filling out the form, ensure you have the following details readily available: - Date of spray application - Name of the chemical spray used - Concentration or dilution ratio of the spray - Area or location where the spray was applied - Quantity of the spray used - Application method (e.g., handheld sprayer, backpack sprayer, etc.) - Name and signature of the person applying the spray 2. Open the printable chemical spray record: Locate the printable record form and open it in a PDF reader or document editor. 3. Enter the date: Start by entering the date of spray application in the designated field. Use a format that is consistent with the form's instructions (e.g., MM/DD/YYYY). 4. Specify the chemical spray used: Indicate the name of the chemical spray being applied. Make sure to write the full name or the specific product name if applicable. 5. Provide the concentration or dilution ratio: If the chemical spray requires dilution, state the concentration or dilution ratio used. This information is essential for tracking the use of chemicals accurately. 6. Record the area or location: Specify the area or location where the spray was applied. This could be a field, garden, specific room, or any other relevant information as required by the form. 7. Mention the quantity used: Enter the quantity of the spray used during the application. This could be in liters, gallons, or any other unit specified in the form. 8. Document the application method: Describe the method used to apply the spray. This could include handheld sprayer, backpack sprayer, airless sprayer, or any other relevant details. 9. Sign and date the record: Leave a space at the bottom of the form for your signature and date. Sign the form to certify that the information provided is accurate. 10. Retain a copy: Make sure to keep a copy of the completed chemical spray record for your records. You may need it for future reference or regulatory inspections. It is important to follow any specific instructions provided on the printable chemical spray record to ensure the accuracy and completeness of the information being recorded.

What information must be reported on printable chemical spray record?

The information that must be reported on a printable chemical spray record may vary depending on the specific regulations and requirements of the jurisdiction. However, some common information that may be required includes: 1. Date and time of the spray incident. 2. Location where the spray incident took place. 3. Chemical spray product used, including its name, brand, and active ingredients. 4. Amount or quantity of the chemical spray used. 5. Description of the purpose or reason for using the chemical spray. 6. Name and contact information of the person(s) who applied the spray. 7. Name and contact information of any witnesses present during the spray incident. 8. Description of any personal protective equipment (PPE) used by the applicator. 9. Any known or observed health or environmental effects resulting from the spray. 10. Any additional remarks or notes related to the spray incident. It is important to consult and follow the specific regulations and guidelines of the relevant authorities when maintaining chemical spray records.

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