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0S O rn <br />Industries LLC <br />Date: <br />of 3 <br />Job Name: J` <br />Address: <br />Equipment working properly <br />Hoses serviceable <br />Pumps serviceable <br />Filters serviceable <br />Tanks secured properly <br />Proper PPE available <br />)< <br />Location Contact info: <br />. L (bot -q 'a, <br />Notes: <br />Temperature <br />g <br />Wind <br />Direction <br />Conditions <br />Spraying Time <br />Targeted Species <br />Type of Site Treated: Rangeland is ' <br />Ag Crop ROW <br />Turf <br />Chemical Name EPA Reg # <br />Applied Amount / Acre <br />Total Product Applied <br />Method of Application ATV iJTV Truck <br />Tractor Backpack Horse <br />Other <br />Gallons per acre: r` Dilution used: `% f , <br />Truck Number: ATV/UTV number: <br />Number of Applicators:. - <br />Billable Hours -1 <br />Piiv, <br />Qualified Supervisor: <br />Applicator: <br />7,1 <br />Commercial applicators are licensed bX olorado Department of Agriculture <br />