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Click ‘Get Form’ to open the pesticide intent document in the editor.
Begin with Section I: Operator Identification. Fill in your name, tax ID (if applicable), address, city, state, zip code, phone number, and email address. Ensure all information is accurate for proper identification.
Proceed to Section II: Pesticide Discharge Identification. Complete Parts A through H by providing details about your pesticide application activities. Include the location of SPDES permit records and any other relevant permits.
In Part E, list all target pests you intend to cover under this Notice of Intent. In Part F, provide the commercial trade names and EPA registration numbers of the pesticides you plan to use.
For Section III: Operator Certification, read through the permit conditions carefully. Certify your understanding by filling in your name, title, and signing the document before submitting it.
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Notice of Intent to Apply Restricted Materials, PR-ENF-126
DEPARTMENT OF PESTICIDE REGULATION. NOTICE OF INTENT TO APPLY RESTRICTED MATERIALS. STATE OF CALIFORNIA. PR-ENF-126 (REV. 01/25). Page 1 of 1. COUNTY NO.Read more
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