➜
Past Chemical Applications
Loading...
Big Marble Farms Chemical Disclosure Form
1. Application Number
2. Department
Select
Greenhouse 1
Greenhouse 2
Greenhouse 3
County Zone 1-4
County Zone 7-8
Redcliff
3. Applicator
Select
Duane Camaisa
Delfin Camaisa
Remson Osuna
Marty Wagenaar
Keith Vis
Other
4. If "Other", please specify applicator name
5. Crop Type
Select
LE
MC
Beefsteak
Roma
TOV/Avalantino
Cocktail
Cherry
Grape Tomatoes
6. Chemical Name
7. Rate Applied per Unit Area
8. Total Amount Used
9. Method of Application
Select
Spray
LVM
Soil Drench
10. Reason for Application
11. Area Treated (Compartments/Rows)
12. Date of Application
13. Time Applied
14. Earliest Allowable Harvest Date
15. Pre-Harvest Interval (PHI)
16. Who was it applied by?
17. Were the label instructions followed?
Yes
No
18. Was the chemical jug label legible?
Yes
No
19. Was the chemical jug stored properly?
Yes
No
Submit
