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Get Tda Pesticide Application Record Form 2015-2024

Tal Volume of Spray Mix, Dust, Granules or Other Materials Applied Per Unit Documentation used to verify training of non-licensed applicator (Mark Applicable Box) □ Direct Supervisor Affidavit Application Date Time Started Name of the person for whom the application was made Product Trade Name EPA Registration Number Is Application Applied in Regulated County: □ Yes Licensed Applicator’s Name and License Number □WPS Handler Card □Signed & Dated Label Location of Land Treated .

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