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PESTICIDE INCIDENT COMPLAINT FORM INSTRUCTIONS The complaint form on the reverse side of this page is provided to assist in the submittal of information associated with an alleged pesticide misuse

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How to fill out pesticide incident complaint form

01

Obtain the pesticide incident complaint form from the relevant authority or website.

02

Fill out the form with details of the incident, including date, time, location, and description of what happened.

03

Provide information about the type of pesticide used, the applicator, and any witnesses to the incident.

04

Include any supporting documents or evidence, such as photographs or samples.

05

Submit the completed form to the appropriate agency or department for review and investigation.

Who needs pesticide incident complaint form?

01

Anyone who has experienced or witnessed a pesticide-related incident can benefit from filling out a pesticide incident complaint form.

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What is pesticide incident complaint form?

The pesticide incident complaint form is a document used to report incidents related to the use of pesticides.

Who is required to file pesticide incident complaint form?

Anyone who has experienced or witnessed a pesticide incident is required to file the pesticide incident complaint form.

How to fill out pesticide incident complaint form?

The pesticide incident complaint form can be filled out by providing details of the incident, including date, time, location, and description of the incident.

What is the purpose of pesticide incident complaint form?

The purpose of the pesticide incident complaint form is to document and report any incidents related to the use of pesticides for further investigation and regulatory action.

What information must be reported on pesticide incident complaint form?

The pesticide incident complaint form must include details such as date and time of incident, location, description of incident, names of individuals involved, and any related health or environmental impacts.

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