2015-07-29_INSPECTION - M2000158

• Permit No: M2000158
• IBM Index Class Name: INSPECTION
• Doc Date: 7/29/2015
• Doc Name: Proof of Weed Control Corrective Action
• From: S&H Mine
• To: DRMS
• Email Name: PSH
• Media Type: D
• Archive: No

A foi� ty
S- 9 172
Terms: Approx.
Eaton Plant
A. Cash unless previous credit authorized Material Chg.
Gilcrest Plant
P.O. Box 338 Eaton, CO 80615
S S
OPPORTUNITY P.O.
Box 344 Gilcrest, CO 80623
[phone]
Agronomy Division
[phone]
balance (21%annual percentage rate).
O Air Max O Ro-Gator Split App.
— _
Customer
Amount: Product:
Landlord _-
Date
Address
Chemical Returns: Clean, unopened packaged chemicals may be returned within 10
Address
days after application of the product. Returns cannot be accepted at a later date as we
Sold By {
City State
-
City _ State
-- -
Applicator
weed control products best suited to help control their weed spectrum. Our customers
make the final determination as to which weed control products they elect to purchase.
Application Date
Note: 7f Tenant/Landlord split is not provided at time of delivery, tenant will be charged ftdl amount.
Applicator Remarks:
conditions and other factors beyond our control effect herbicide performance.
Billing: Regular O Special Terms
Billing: Regular O Special Terms
License Holder
Booking O Pre -pay 0 Farmplan O
Booking O Pre -pay O Farmplan O
us within 30 days of the application of the product.
Units N
P
K
SS
—r -
Es Zn B Mn Cu �,
Fe
Applicator ID
-
_
EXP. Date
CLbs. Acre
Crop
Field
Unit
Target Pest: Weeds
Acres
Insects -
jRestrictions:
Entry
Other
MATERIAL
PRODUCTS
UNIT
TOTAL
Lbs. or Gals.
PRICE
AMOUNT
i
� I
I
Total Lbs. Acres Spread Rate # / Cu. Ft
Terms: Approx.
i —
A. Cash unless previous credit authorized Material Chg.
I and approved. —
-I
- —)
B. Account due within 30 days of Sales Tax ' +
Directions:
statement.
Application
C. 1.75% per month charged on past due
Charge
balance (21%annual percentage rate).
O Air Max O Ro-Gator Split App.
— _
Approx. Cost
Amount: Product:
i O Cart O Other --------
RECEIVED BY: X
Chemical Returns: Clean, unopened packaged chemicals may be returned within 10
days after application of the product. Returns cannot be accepted at a later date as we
cannot receive credit from our suppliers.
-
Bulk Chemicals cannot be returned.
-- -
Weed Control: We promise to do our best to help each and every customer select the
weed control products best suited to help control their weed spectrum. Our customers
make the final determination as to which weed control products they elect to purchase.
- - -
As a dealer, we make NO GUARANTEE of weed control from any herbicide, as weather
Applicator Remarks:
conditions and other factors beyond our control effect herbicide performance.
If you are not satisfied with the weed control you have received from any product pur-
chased from us, we will contact the manufacturer of the product provided you. Contact
us within 30 days of the application of the product.