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RECEIVED <br />Montrose County Weed Mitigation Department <br />161 S. Townsend Ave, Montrose, CO 81401 FEB 2 7 2014 <br />Division of Reclamation, <br />Date: / 13 Location: d2tiJ :�4 Mining & Safety <br />Start Time: Address: <br />End Time: Contact Info: �5/� - tS.21& <br />Mileage Start: 6-3 2, Mileage End: <br />East End West End ROW /, I Pit Grant Funded Facilities USFS <br />BLM CDOT Airport Special Project B Other Gov. Other Agency <br />Tank/Herbicide #: <br />Herbicide Applied: <br />EPA Reg. #: <br />Manufacturer: <br />Application Rate <br />Tank/Herbicide #: <br />Herbicide Applied: <br />EPA Reg. #: <br />Manufacturer: <br />Application Rate <br />Tank/Herbicide #: <br />Herbicide Applied: <br />EPA Reg. #: J-j 467 /D <br />Manufacturer: G Y\ .V © Z. <br />Application Rate <br />Tank/Herbicide #: <br />Total Herbicide <br />Herbicide Applied: <br />Gallons Water <br />EPA Reg. #: <br />Manufacturer: <br />VAT <br />Application Rate <br />.95 gftk <br />Surfactant Applied: <br />Guardian Plus <br />Manufacturer: <br />Cornbelt <br />Application Rate: <br />1.5 quarts per /100 gal carrier <br />Surfactant Applied: <br />Premier 90 <br />Manufacturer: <br />Cornbelt <br />Application Rate: <br />1 quart per /100 gal carrier <br />Dye Used: <br />Other: <br />Other: <br />Target Species: HC RKW F-1 SKW F-1 YST F-1 YTF E] PLS [] Broadleaves � Grasses If <br />v <br />Application Type: M Truck [3 UTV Argo Backpack [] Mechanical F-1 Other <br />Transportation: R 03 Chevy S 06 Chevy Ford Dodge 11 Tandem Axle 11 Single Axle <br />'ank # <br />Total Herbicide <br />Acres Treated <br />Gallons Water <br />Total Acres Treated <br />NPDES Application <br />VAT <br />Vegetation Conditions <br />.95 gftk <br />3 <br />b,3? <br />1�•(�to <br />10 <br />)tal Cost: <br />Labor: <br />Herbicide: <br />Adjuvant: <br />Notes: AAk <br />llJl ,C1 P1 -r <br />Applicator Name <br />I7 <br />Total Acres Treated <br />NPDES Application <br />VAT <br />Vegetation Conditions <br />Notes: AAk <br />llJl ,C1 P1 -r <br />