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Pesticide Application Record (Details as required by regulation) Checklist

Stay compliant & protect your crops! Download our free, comprehensive Pesticide Application Record checklist for agriculture. Ensure accurate documentation, meet regulatory requirements, and safeguard your farm's future. Get organized & avoid costly penalties!

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Application Information

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Basic details about the application event.

Date of Application

Time of Application (Start)

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GPS Coordinates of Application Site

Area Treated (e.g., Acres, Hectares)

Application Method

If 'Other' Application Method, Please Specify:

Description of Application Location (e.g., Field Name, Section)

Applicator Information

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Details regarding the person(s) applying the pesticide. Crucial for traceability and certification.

Applicator Name (First Name)

Applicator Name (Last Name)

Applicator License/Certification Number

License/Certification Expiration Date

Applicator Hours of Training (if applicable)

Applicator Employee Status

Applicator Signature

Pest & Crop Information

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Details concerning the pest being targeted and the crop being treated. Essential for proper selection and application.

Crop Type

Crop Variety/Cultivar (if known)

Crop Growth Stage (e.g., V4, R2, BBCH scale)

Detailed Description of Crop Condition (health, vigor, etc.)

Target Pest(s) (Primary)

Detailed Description of Pest Identification & Infestation Level

Area Treated (acres or hectares)

Notes regarding pest pressure or infestation history

Pesticide Product Information

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Specific details about the pesticide product used in the application.

Pesticide Product Name (as listed on label)

EPA Registration Number

Amount of Product Applied (Units)

Concentration of Product Used (%)

Formulation Type (e.g., EC, WP, GR)

Any Dilution Instructions Followed (Record specifics)

Upload Product Label (if required by regulation)

Application Details

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Specifics about how the pesticide was applied – method, equipment, rates, timing, etc.

Application Date

Application Start Time

0:00
0:15
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1:15
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Application Rate (Pounds per Acre/Hectare)

Amount of Pesticide Applied (Gallons/Liters)

Application Method

Nozzle Type (If Applicable)

Equipment Used (Detailed Description)

Spray Volume (GPA/GPM or L/ha)

Application Equipment Calibration Status

Environmental Conditions

NaN of 8

Weather and environmental factors at the time of application. Critical for efficacy and risk mitigation.

Date of Application

Time of Application (Start)

0:00
0:15
0:30
0:45
1:00
1:15
1:30
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2:15
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Air Temperature (°C/°F)

Wind Speed (km/h or mph)

Wind Direction

Sky Condition

Soil Moisture (Visual Estimate)

Additional Environmental Notes (e.g., precipitation forecasts, unusually humid conditions)

Buffer Zones & Restrictions

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Documentation of adherence to buffer zones and any specific application restrictions.

Were buffer zones implemented?

Buffer zone width (feet) – Water bodies

Buffer zone width (feet) – Sensitive Areas (e.g., residential, organic farms)

Were any local restrictions applied?

Describe any local restrictions applied (if applicable)

Was a Drift Reduction Technology Used?

Describe Drift Reduction Technology used (if applicable)

Was a No-Spray Period Observed?

Record Keeping & Notifications

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Details related to record storage, reporting requirements, and any necessary notifications.

Record Creation Date

Record Keeper Name

Notes/Comments (e.g., deviations from label, observations)

Record Retention Method

Record Retention Period (Years)

Notification Required (e.g., water body proximity)?

Details of any Notifications Sent (Recipient, Date, Method)

Supporting Documentation (e.g., maps, label copies)

Record Keeper Signature

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