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5j v <br /> UNITED STATE DEPARTMENT OF THE INTERIOR <br /> €� BUREA U OF LAND MANAGEMENT <br /> PESTICIDE APPLICATION RECORD <br /> Project Name: YV1 - !,Z Ct of <br /> Operator: <br /> Pesticide Use Proposal Number: <br /> NEPA Reference Number: <br /> 1. APPLICATOR: <br /> a. Name of Applicator or Employee(s)Making the Application: <br /> n©r <br /> 2. APPLICATION: ro f <br /> a. Application Dates: <br /> b. Time Frame of Application: (Q : (5 42me <br /> rr c. Location: V ate_ -L4 vu--, VL <br /> d. Application Equipment: i -Qj rL i <br /> 3. PESTICIDE INFORMATION: r <br /> a. Trade Name: <br /> b. Company/Manufacturer/Formulator's Name: ' <br /> c. Pesticide Formulation Type: ; d d✓.l aw Q, <br /> t <br /> d. Rate of Application—Per Acre: <br /> i. Formulated Product: �2 .,, l•S Q L / <br /> ii. Active Ingredient/Acid Equivalent: <br /> iii. Total Spray Solution Amount: s <br /> 4. APPLICATION CONDITIONS: <br /> L <br /> a. Wind Speed: (7 . -3 c. Wind Direction: <br /> � <br /> b. Air Temperature: 7S_ d. Surface Conditions: _Ax <br />