Herbicide Application Record (Product, Rate, Date, Field) Checklist
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This Template was installed 5 times.
Application Information
General details about the herbicide application event.
Application Date
Application Time (Start)
Application Purpose (e.g., pre-emergent, post-emergent)
Brief Description of Application (e.g., weed stage, weather conditions)
Application Method (e.g., Ground, Aerial)
Applicator Skill Level (1-5, 1=Beginner, 5=Expert)
Any Issues Encountered During Application?
Product Details
Specifics regarding the herbicide product used.
Herbicide Product Name
If Other, Specify Product Name
Active Ingredient Concentration (%)
Product Formulation (e.g., EC, WP, GR)
Product Label (Optional)
EPA Registration Number
Application Rate & Timing
Details about the application rate, volume, and timing.
Herbicide Rate (per acre/hectare)
Units of Rate
Water Volume (per acre/hectare)
Water Volume Units
Application Date
Application Time
Application Method
Notes on Application Timing/Conditions
Field Information
Identification and characteristics of the field treated.
Field Name/Identifier
Field Size (Acres/Hectares)
Crop Type
If Other Crop, Specify:
Planting Date
Soil Type & Condition Notes (e.g., sandy loam, compacted)
GPS Coordinates (Latitude/Longitude)
Field Elevation (Feet/Meters)
Application Equipment & Conditions
Details about the equipment used and environmental conditions during application.
Application Method
Sprayer Ground Speed (mph)
Spray Volume (GPA)
Nozzle Size (inches)
Wind Speed (mph)
Wind Direction
Date of Application
Time of Application
Weather Conditions Notes
Applicator & Certification
Information about the person performing the application and their qualifications.
Applicator Name (First and Last)
Applicator Employee ID (if applicable)
Years of Experience Applying Herbicides
Applicator License/Certification Type
License/Certification Number
License/Certification Expiration Date
Any Relevant Training or Refresher Courses Completed (e.g., Resistance Management)
Supervision Required?
Applicator Signature
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