EP 1130-2-540
15 Nov 96
j. EPA Classification: Indicate whether the recommended pesticide is classified by EPA
as a general-use or restricted-use pesticide.
k. Amount: Provide the anticipated amount of pesticide that will be applied during the
upcoming year, or the actual amount applied during the previous year, whichever is applicable to
the report being prepared.
l. Acreage: Indicate the area to be treated or which was treated, depending on the report,
in either acres or square feet, whichever is more practical. Fumigation or aerosol application will
be reported in cubic feet of area treated. Where repeated applications are proposed for the same
area, report only the unit area to be treated in one application.
m. Target Pest: Identify the pest to be controlled by common name. When necessary for
clarity, include scientific names. The target pest(s) must be clearly identified in order to justify the
use and choice of pesticides.
n. Locations: Indicate the type of area(s) to be treated. Example: parking lots, lawns, or
maintenance yards.
SAMPLE FORMAT
ANNUAL PEST CONTROL PLAN
---------------------------------------------------------------------------------
ANTICIPATED USAGE REPORT___________ACTUAL USAGE REPORT___________
FIELD
OFFICE:_______________________DISTRICT:__________________________
CALENDAR YEAR:_________ DATE:_____________ PAGE:_______________
====================================================================
PESTICIDE TRADE NAME: EPA CLASS:
EPA REGISTRATION #:
___________________
_______________
___________________
TARGET PEST:__________________________________________
LOCATION DESCRIPTION: ___________________________________________
_________________________________________________________________
TOTAL ESTIMATED
TOTAL ESTIMATED
QUANTITY:____________________
ACREAGE:_______________
====================================================================
PESTICIDE TRADE NAME: EPA CLASS:
EPA REGISTRATION #:
_____________________
_____________
__________________
TARGET PEST:_____________________________________________________
LOCATION DESCRIPTION: ___________________________________________
_________________________________________________________________
TOTAL ESTIMATED
TOTAL ESTIMATED
QUANTITY:____________________
ACREAGE:_______________
G-2
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