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Tank # <br />Total Herbicide <br />Acres Treated <br />Gallons Water <br />'�'hf." of <br />- Way cy, <br />/gist 'c, <br />Date: <br />Start Time: <br />End Time: <br />Mileage Start: <br />East End <br />BLM <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. #: <br />Manufacturer: <br />Application Rate <br />Target Species: <br />Other: <br />,,- <br />Total Cost: <br />Labor: <br />Herbicide: <br />Adjuvant: / q. ?G <br />Montrose County Weed Mitigation Department <br />161 S. Townsend Ave, Montrose, CO 81401 <br />7 , D <br />yt too <br />4/ 9a <br />West End <br />CDOT <br />Location: <br />Address: <br />Contact Info: <br />Mileage End: <br />R_ Wi Gravel Pit <br />Airport <br />Application Type: Truck UTV ❑ Argo <br />Transportation: ❑ 03 Chevy 06 Chevy Ford <br />Grant Funded <br />Special Project <br />Tank/Herbicide #: <br />Herbicide Applied: <br />EPA Reg. #: <br />Manufacturer: <br />Application Rate <br />Surfactant Applied: Guardian Plus <br />Manufacturer: Cornbelt <br />Application Rate: 1.5 quarts per /100 gal carrier <br />Surfactant Applied: <br />Manufacturer: <br />Application Rate: <br />Dye Used: <br />Other: <br />Other: <br />Facilities <br />Other Gov. <br />Premier 90 <br />Cornbelt <br />1 quart per /100 qal carrier <br />USFS <br />Other Agency <br />HC RKW SKW YST YTF ❑ PLS Broadleaves El Grasses <br />Backpack ❑ Mechanical f Other <br />❑ Dodge <br />Notes: <br />❑ Tandem Axle ❑ Single Axle <br />04/0-, <br />Applicator Name <br />Total Acres Treated <br />NPDES Application <br />Vegetation Conditions <br />f <br />� '� "� � --' � - ply Air) 44/4_,46 <br />