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- Click ‘Get Form’ to open the pesticide report form in the editor.
- Begin by entering your Certification ID Number, Last Name, and First Name in the designated fields. If applicable, include your Business/Agency Registration Number.
- If no commercial applications were conducted this year, check the box provided.
- For each pesticide application, fill in the EPA Registration Number as it appears on the product label. Ensure you include all dashes.
- Next, enter the Product Name and Quantity Used. Remember to use decimals for quantities and select appropriate units from the provided abbreviations.
- Input the Date of Application in MMDD format and specify the County Code where the application took place.
- Finally, provide the Address, Municipality, and ZIP Code of where the pesticide was applied.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2001 | 4.9 Satisfied (58 Votes) |
What is EPA form 3540-16?
EPA Form 3540-16 is used to submit pesticide reports for registered pesticide and device producing establishments.
What are the EPA pesticides violations?
EPA Enforcement EPA prohibits the sale and distribution of unregistered, adulterated, or misbranded pesticides and the use of any registered pesticide in a manner inconsistent with its labeling.
How do I report a pesticide incident to the EPA?
You can report pesticide incidents online, or call your Regional EPA Office to identify the right people to investigate. Ask to speak with someone in the pesticide program. If youre not sure where to start, call the National Pesticide Information Center (NPIC) at 800-858-7378.
What is a form of pesticide?
About pesticides Examples include insecticides, fungicides, herbicides, molluscicides, and plant growth regulators. They can exist in many forms, such as solid granules, powders or liquids and consist of one or more active substances co-formulated with other materials.
What can be reported to EPA?
Examples of Specific Incidents of Pollution That Must Be Reported to the EPA Directly Dumping of waste or a hazardous chemical on land or into a waterway. Storage of hazardous waste. Asbestos removal, storage and disposal. Release of hazardous chemicals or substances into the air. Lead hazards. Radon risks and testing.
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People also ask
What are the requirements for a FIFRA report?
FIFRA requires that a company register with EPA any establishment at which any pesticide production activity, including pesticide packaging and labeling, is performed. Each producer operating a production establishment must submit an annual pesticide production report.
What is considered a violation of EPA?
Common Violations Typical violations which result in investigations may involve, but are not limited to: Illegal disposal of hazardous waste. Export of hazardous waste without the permission of the receiving country. Illegal discharge of pollutants to a water of the United States.
Can I call the EPA on my neighbor?
If you are seeing an environmental event that may lead to an immediate threat to human health or the environment, call 911, then report it to the National Response Center at: 1-800-424-8802. Choose No to continue reporting a possible violation that is not an emergency.
Related links
This report describes basic elements, or a framework, for evaluating scientific information on the adverse effects of physical and chemical stressors on theRead more
Jan 14, 2026 You must print, sign and date the form. Submit reports to the pesticide establishment coordinator where your company headquarters is located.Read more
Commercial Applicator Pesticide Use Annual Report Form 26 (external link to NYS DEC); Directions for Completing the NYS DEC Annual Pesticide Report (PDF)Read more