2012-08-27_REPORT - M1990098

• Permit No: M1990098
• IBM Index Class Name: REPORT
• Doc Date: 8/27/2012
• Doc Name: ANNUAL FEE/REPORT
• From: ASPHALT PAVING
• To: DRMS
• Media Type: D
• Archive: No

Qty of Treatment : 4444- F., jo
unit or measure : f14././.....) n N rv+ i/r
Temperature : 90
Posting : N / A
Wind Direction : W
GPA Calibrated @ : a -
-J5
Gal. H2O Used: i 76
Wind Speed : t"
Change Orders & Additional Fees : .
Customer's Signature for Changes:
Field Notes : /72/ -i'4 /1 %J) II.0
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! 'f4' .-,-,//,- , ' C .. 41/ Ile° (! ., 0 f`, / 3r /s/ rr o ,- nC° ' 4/
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to complete the work under
the foregoing terms on this
Customer Notes :
Posting Requirements : EWC will follow all State requirements and will post at special request by customer.
Precautions to Follow : All personel and pets must remain off until dry. Grazing livestock to remain off for 7 days.
Payment Terms : Payments are due at the time of application unless otherwise stated on this form.
Extreme Weed Control, LLC. (EWC), A Colorado Limited Liability Company agrees to provide all labor and materials necessary
this Work Order Contract and the Customer agrees to accept and pay for the work performed according to this Estimate upon
Estimate Signature Page / Work Order Contract.
Commercial applicators are licensed by the Colorado Department of Agriculture.
EXTREME WEED CONTROL
13401 HARVEST MILE ROAD
COMMERCE CITY, CO 80022 -9201 y`
Company :
Contact Name :
Address :
City, State, Zip :
Telephone # :
Job Description :
Description of Treatment Area :
Estimate # :
QS Applicator :
CO Applicator : j efr
Tech Applicator : -
AspNo
Ak X,C
C•
JobType: Cog1r?1
Herbicide Type : 5c' /oL l %✓�
Application Method :jryyr
Treatment Area : N frTl'YC
RAY/ /) t7
MME
\ --4YfED
Herbicide Application Record 2012
c o
Service Date : (, •/d
Truck #: /0
l-*
Equipment : C74 r
Target Pest : *9005
Arrival Time : 4! a /}
Departure Time : . Pn
Warranty Date : -
Next Appl. Date :
•
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P /oltcr 8 ?io0 ?- n9
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Input & EPA #
PH. 303- 853 -920
FAX' 303- 853 -98
WWW.EXTREMEWEEDCONTROL COM
Service Address:
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Herbicides Needed
Rate/AC
21(0 o'z
70
2'
o
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Qty Used
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