Pesticide Application Record Ornamental and Turf AGENCY ... 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the 'Person or firm' details, including Name, Address, City/State/Zip, and Phone number. This information identifies who is responsible for the application.
3. Fill in the Licensed Applicator’s Name and Business Name (if applicable), along with their License Number and contact details.
4. Record the Date of application, Start Time, and Finish Time. Ensure you circle a.m. or p.m. as appropriate.
5. Indicate the Target Pests by checking (X) the relevant boxes from the provided list.
6. Describe Specific Site(s) treated, such as lawns or trees, and provide details on Concentration or rate of application per unit of measure.
7. Document the Size of area treated and Total amount applied using appropriate units like gallons or pounds.
8. Specify the Method of application used during treatment.
9. List all Pesticide Information for each pesticide used in the tank mix, including Brand Name, Concentration, EPA Registration Number, and Rate Per Unit of Application.
10. Complete any optional information such as Wind direction, Wind velocity, Temperature during application, and comments if necessary.

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