QID Nursery and Floriculture Chemical Use Survey Supplement

16

	VERSION 01	POID ___ ___ ___ ___ ___ ___ ___ ___ ___	SUBTRACT ___ ___	T-TYPE 0		TABLE 000	LINE 00
JANUARY 2009
NURSERY and FLORICULTURE
CHEMICAL USE SURVEY
CHEMICAL APPLICATIONS TABLE
SUPPLEMENT

CHEMICAL APPLICATION SUPPLEMENT
			OFFICE USE EDIT TABLE		1 Incomplete 3 Valid Zero					314		OFFICE USE LINES IN TABLE				T-TYPE 1				TABLE 001		LINE 99		101
PRODUCTION CATEGORY CODES FOR COLUMN 4																	LOCATION CODES FOR COLUMN 5
NURSERY 1 Transplants for commercial vegetable and strawberry production 2 Propagative nursery material or lining-out stock 3 Broadleaf evergreens 4 Coniferous evergreens 5 Deciduous shade trees 6 Deciduous flowering trees 7 Deciduous shrubs 8 Fruit and nut plants 9 Christmas trees 10 Palms 11 Ornamental grasses 12 Other woody ornamentals and vines 20 Non-production area							FLORICULTURE 13 Cut flowers 14 Flowering plants (potted) 15 Bedding plants (flat, potted, hanging) 16 Foliage plants (potted or hanging) 17 Propagative floriculture material 18 Cut cultivated greens 19 Herbaceous perennials 20 Non-production area										Greenhouse (enclosed) Shade Structure (frames, slat, saran, cloth, screen, non-enclosed greenhouse, etc.) Natural Shade Area (palm, citrus, etc.) In The Open Production Area Perimeter (non-production areas)
						1					2		3						4				5
CHEMICAL PRODUCT NAME				L I N E		What products were applied? [Enter product code.]					Was this product bought in liquid or dry form? [Enter L or D.]		Was this part of a tank mix? [If tank mix, enter line number of first product in mix.]						What was this chemical mostly applied to? [Enter code from above.] CODE				Where was this product mostly applied? [Enter code from above.] CODE
				01		301							302						303				304
				02		301							302						303				304
				03		301							302						303				304
				04		301							302						303				304
				05		301							302						303				304
				06		301							302						303				304
				07		301							302						303				304
				08		301							302						303				304
				09		301							302						303				304
				10		301							302						303				304
				11		301							302						303				304
				12		301							302						303				304
[For pesticides not listed in Respondent Booklet, specify---]
Line No.		Pesticide Type (Herbicide, Insecticide, Fungicide, etc.)							Tradename and Formulation									Form Purchased (Liquid or Dry)				EPA No.
_____________		__________________________							____________________________									________________				_________________
_____________		__________________________							____________________________									________________				_________________
_____________		__________________________							____________________________									________________				_________________
_____________		__________________________							____________________________									________________				_________________

UNIT CODES FOR COLUMN 9											METHOD CODES FOR COLUMN 11												APPLICATOR CODES FOR COLUMN 12
1 Pounds 12 Gallons 13 Quarts 14 Pints 15 Liquid Ounces 20 Teaspoons 21 Tablespoons				28 Dry Ounces 30 Grams 40 Kilograms 41 Liters 42 Milliliters 50 Other, bags, WSP, etc. (Specify unit & weight________)							1 Hand held back pack sprayer 2 Hand held wand/gun/boom from power hydraulic sprayers 3 Hand held granular shakers 4 Hand held granular rotary applicator (whirly bird, belly grinder) 5 Hand held foggers 6 Dusting 7 Overhead rail sprayers (track sprayers) 8 Root ball/container/cutting/flower dip 9 Drench 10 Stationary fogger, aerosols, misters, electrostatic sprayers, smokers 11 Tractor powered boom sprayer 12 Tractor powered air blast or mister 13 Aerial application 14 Chemigation 15 Machine injection, branded, broadcast, knifed in 16 Other, (Specify____________________)												1 Licensed operator/employee pesticide applicator 2 Unlicensed operator/employee under the direction of licensed applicator 3 Hired custom applicator (Not an employee of operation) 4 Other, (Specify:________________)
	6						7					8								9				10	11	12
L I N E	How much area was treated?						What was the total amount applied per application?					How much was applied per acre OR per 1,000 square feet per application?								UNIT [Enter code from above.] CODE				How many times was this applied? NUMBER	How was this product applied? [Enter code from above. CODE	Who made the application(s)? [Enter code from above.] CODE
	ACRES		OR		SQUARE FEET							RATE PER ACRE			OR		RATE PER 1,000 SQUARE FEET
01	305	.___			306		307		.___			308		.___ ___			309		.___ ___	310				311	312	313
02	305	.___			306		307		.___			308		.___ ___			309		.___ ___	310				311	312	313
03	305	.___			306		307		.___			308		.___ ___			309		.___ ___	310				311	312	313
04	305	.___			306		307		.___			308		.___ ___			309		.___ ___	310				311	312	313
05	305	.___			306		307		.___			308		.___ ___			309		.___ ___	310				311	312	313
06	305	.___			306		307		.___			308		.___ ___			309		.___ ___	310				311	312	313
07	305	.___			306		307		.___			308		.___ ___			309		.___ ___	310				311	312	313
08	305	.___			306		307		.___			308		.___ ___			309		.___ ___	310				311	312	313
09	305	.___			306		307		.___			308		.___ ___			309		.___ ___	310				311	312	313
10	305	.___			306		307		.___			308		.___ ___			309		.___ ___	310				311	312	313
11	305	.___			306		307		.___			308		.___ ___			309		.___ ___	310				311	312	313
12	305	.___			306		307		.___			308		.___ ___			309		.___ ___	310				311	312	313

PRODUCTION CATEGORY CODES FOR COLUMN 4													LOCATION CODES FOR COLUMN 5
NURSERY 1 Transplants for commercial vegetable and strawberry production 2 Propagative nursery material or lining-out stock 3 Broadleaf evergreens 4 Coniferous evergreens 5 Deciduous shade trees 6 Deciduous flowering trees 7 Deciduous shrubs 8 Fruit and nut plants 9 Christmas trees 10 Palms 11 Ornamental grasses 12 Other woody ornamentals and vines 20 Non-production area					FLORICULTURE 13 Cut flowers 14 Flowering plants (potted) 15 Bedding plants (flat, potted, hanging) 16 Foliage plants (potted or hanging) 17 Propagative floriculture material 18 Cut cultivated greens 19 Herbaceous perennials 20 Non-production area								1 Greenhouse (enclosed) 2 Shade Structure (frames, slat, saran, cloth, screen, non-enclosed greenhouse, etc.) 3 Natural Shade Area (palm, citrus, etc.) 4 In The Open Production Area 5 Perimeter (non-production areas)
				1				2	3					4			5
CHEMICAL PRODUCT NAME			L I N E	What products were applied? [Enter product code.]				Was this product bought in liquid or dry form? [Enter L or D.]	Was this part of a tank mix? [If tank mix, enter line number of first product in mix.]					What was this chemical mostly applied to? [Enter code from above.] CODE			Where was this product mostly applied? [Enter code from above.] CODE
			13	301					302					303			304
			14	301					302					303			304
			15	301					302					303			304
			16	301					302					303			304
			17	301					302					303			304
			18	301					302					303			304
			19	301					302					303			304
			20	301					302					303			304
			21	301					302					303			304
			22	301					302					303			304
			23	301					302					303			304
			24	301					302					303			304
			25	301					302					303			304
			26	301					302					303			304
			27	301					302					303			304
[For pesticides not listed in Respondent Booklet, specify---]
Line No.		Pesticide Type (Herbicide, Insecticide, Fungicide, etc.)					Tradename and Formulation					Form Purchased (Liquid or Dry)				EPA No.
_____________		__________________________					____________________________					________________				_________________
_____________		__________________________					____________________________					________________				_________________
_____________		__________________________					____________________________					________________				_________________

UNIT CODES FOR COLUMN 9									METHOD CODES FOR COLUMN 11								APPLICATOR CODES FOR COLUMN 12
1 Pounds 12 Gallons 13 Quarts 14 Pints 15 Liquid Ounces 20 Teaspoons 21 Tablespoons				28 Dry Ounces 30 Grams 40 Kilograms 41 Liters 42 Milliliters 50 Other, bags, WSP, etc. (Specify unit & weight________)					1 Hand held back pack sprayer 2 Hand held wand/gun/boom from power hydraulic sprayers 3 Hand held granular shakers 4 Hand held granular rotary applicator (whirly bird, belly grinder) 5 Hand held foggers 6 Dusting 7 Overhead rail sprayers (track sprayers) 8 Root ball/container/cutting/flower dip 9 Drench 10 Stationary fogger, aerosols, misters, electrostatic sprayers, smokers 11 Tractor powered boom sprayer 12 Tractor powered air blast or mister 13 Aerial application 14 Chemigation 15 Machine injection, branded, broadcast, knifed in 16 Other, (Specify____________________)								1 Licensed operator/employee pesticide applicator 2 Unlicensed operator/employee under the direction of licensed applicator 3 Hired custom applicator (Not an employee of operation) 4 Other, (Specify:________________)
	6					7				8					9			10	11	12
L I N E	How much area was treated?					What was the total amount applied per application?				How much was applied per acre OR per 1,000 square feet per application?					UNIT [Enter code from above.] CODE			How many times was this applied? NUMBER	How was this product applied? [Enter code from above. CODE	Who made the application(s)? [Enter code from above.] CODE
	ACRES		OR		SQUARE FEET					RATE PER ACRE		OR	RATE PER 1,000 SQUARE FEET
13	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
14	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
15	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
16	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
17	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
18	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
19	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
20	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
21	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
22	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
23	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
24	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
25	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
26	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
27	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313

PRODUCTION CATEGORY CODES FOR COLUMN 4													LOCATION CODES FOR COLUMN 5
NURSERY 1 Transplants for commercial vegetable and strawberry production 2 Propagative nursery material or lining-out stock 3 Broadleaf evergreens 4 Coniferous evergreens 5 Deciduous shade trees 6 Deciduous flowering trees 7 Deciduous shrubs 8 Fruit and nut plants 9 Christmas trees 10 Palms 11 Ornamental grasses 12 Other woody ornamentals and vines 20 Non-production area					FLORICULTURE 13 Cut flowers 14 Flowering plants (potted) 15 Bedding plants (flat, potted, hanging) 16 Foliage plants (potted or hanging) 17 Propagative floriculture material 18 Cut cultivated greens 19 Herbaceous perennials 20 Non-production area								1 Greenhouse (enclosed) 2 Shade Structure (frames, slat, saran, cloth, screen, non-enclosed greenhouse, etc.) 3 Natural Shade Area (palm, citrus, etc.) 4 In The Open Production Area 5 Perimeter (non-production areas)
				1				2	3					4			5
CHEMICAL PRODUCT NAME			L I N E	What products were applied? [Enter product code.]				Was this product bought in liquid or dry form? [Enter L or D.]	Was this part of a tank mix? [If tank mix, enter line number of first product in mix.]					What was this chemical mostly applied to? [Enter code from above.] CODE			Where was this product mostly applied? [Enter code from above.] CODE
			28	301					302					303			304
			29	301					302					303			304
			30	301					302					303			304
			31	301					302					303			304
			32	301					302					303			304
			33	301					302					303			304
			34	301					302					303			304
			35	301					302					303			304
			36	301					302					303			304
			37	301					302					303			304
			38	301					302					303			304
			39	301					302					303			304
			40	301					302					303			304
			41	301					302					303			304
[For pesticides not listed in Respondent Booklet, specify---]
Line No.		Pesticide Type (Herbicide, Insecticide, Fungicide, etc.)					Tradename and Formulation					Form Purchased (Liquid or Dry)				EPA No.
_____________		__________________________					____________________________					________________				_________________
_____________		__________________________					____________________________					________________				_________________
_____________		__________________________					____________________________					________________				_________________

UNIT CODES FOR COLUMN 9									METHOD CODES FOR COLUMN 11								APPLICATOR CODES FOR COLUMN 12
1 Pounds 12 Gallons 13 Quarts 14 Pints 15 Liquid Ounces 20 Teaspoons 21 Tablespoons				28 Dry Ounces 30 Grams 40 Kilograms 41 Liters 42 Milliliters 50 Other, bags, WSP, etc. (Specify unit & weight________)					1 Hand held back pack sprayer 2 Hand held wand/gun/boom from power hydraulic sprayers 3 Hand held granular shakers 4 Hand held granular rotary applicator (whirly bird, belly grinder) 5 Hand held foggers 6 Dusting 7 Overhead rail sprayers (track sprayers) 8 Root ball/container/cutting/flower dip 9 Drench 10 Stationary fogger, aerosols, misters, electrostatic sprayers, smokers 11 Tractor powered boom sprayer 12 Tractor powered air blast or mister 13 Aerial application 14 Chemigation 15 Machine injection, branded, broadcast, knifed in 16 Other, (Specify____________________)								1 Licensed operator/employee pesticide applicator 2 Unlicensed operator/employee under the direction of licensed applicator 3 Hired custom applicator (Not an employee of operation) 4 Other, (Specify:________________)
	6					7				8					9			10	11	12
L I N E	How much area was treated?					What was the total amount applied per application?				How much was applied per acre OR per 1,000 square feet per application?					UNIT [Enter code from above.] CODE			How many times was this applied? NUMBER	How was this product applied? [Enter code from above. CODE	Who made the application(s)? [Enter code from above.] CODE
	ACRES		OR		SQUARE FEET					RATE PER ACRE		OR	RATE PER 1,000 SQUARE FEET
28	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
29	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
30	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
31	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
32	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
33	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
34	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
35	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
36	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
37	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
38	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
39	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
40	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
41	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313

PRODUCTION CATEGORY CODES FOR COLUMN 4													LOCATION CODES FOR COLUMN 5
NURSERY 1 Transplants for commercial vegetable and strawberry production 2 Propagative nursery material or lining-out stock 3 Broadleaf evergreens 4 Coniferous evergreens 5 Deciduous shade trees 6 Deciduous flowering trees 7 Deciduous shrubs 8 Fruit and nut plants 9 Christmas trees 10 Palms 11 Ornamental grasses 12 Other woody ornamentals and vines 20 Non-production area					FLORICULTURE 13 Cut flowers 14 Flowering plants (potted) 15 Bedding plants (flat, potted, hanging) 16 Foliage plants (potted or hanging) 17 Propagative floriculture material 18 Cut cultivated greens 19 Herbaceous perennials 20 Non-production area								1 Greenhouse (enclosed) 2 Shade Structure (frames, slat, saran, cloth, screen, non-enclosed greenhouse, etc.) 3 Natural Shade Area (palm, citrus, etc.) 4 In The Open Production Area 5 Perimeter (non-production areas)
				1				2	3					4			5
CHEMICAL PRODUCT NAME			L I N E	What products were applied? [Enter product code.]				Was this product bought in liquid or dry form? [Enter L or D.]	Was this part of a tank mix? [If tank mix, enter line number of first product in mix.]					What was this chemical mostly applied to? [Enter code from above.] CODE			Where was this product mostly applied? [Enter code from above.] CODE
			42	301					302					303			304
			43	301					302					303			304
			44	301					302					303			304
			45	301					302					303			304
			46	301					302					303			304
			47	301					302					303			304
			48	301					302					303			304
			49	301					302					303			304
			50	301					302					303			304
			51	301					302					303			304
			52	301					302					303			304
			53	301					302					303			304
			54	301					302					303			304
			55	301					302					303			304
[For pesticides not listed in Respondent Booklet, specify---]
Line No.		Pesticide Type (Herbicide, Insecticide, Fungicide, etc.)					Tradename and Formulation					Form Purchased (Liquid or Dry)				EPA No.
_____________		__________________________					____________________________					________________				_________________
_____________		__________________________					____________________________					________________				_________________
_____________		__________________________					____________________________					________________				_________________

UNIT CODES FOR COLUMN 9									METHOD CODES FOR COLUMN 11								APPLICATOR CODES FOR COLUMN 12
1 Pounds 12 Gallons 13 Quarts 14 Pints 15 Liquid Ounces 20 Teaspoons 21 Tablespoons				28 Dry Ounces 30 Grams 40 Kilograms 41 Liters 42 Milliliters 50 Other, bags, WSP, etc. (Specify unit & weight________)					1 Hand held back pack sprayer 2 Hand held wand/gun/boom from power hydraulic sprayers 3 Hand held granular shakers 4 Hand held granular rotary applicator (whirly bird, belly grinder) 5 Hand held foggers 6 Dusting 7 Overhead rail sprayers (track sprayers) 8 Root ball/container/cutting/flower dip 9 Drench 10 Stationary fogger, aerosols, misters, electrostatic sprayers, smokers 11 Tractor powered boom sprayer 12 Tractor powered air blast or mister 13 Aerial application 14 Chemigation 15 Machine injection, branded, broadcast, knifed in 16 Other, (Specify____________________)								1 Licensed operator/employee pesticide applicator 2 Unlicensed operator/employee under the direction of licensed applicator 3 Hired custom applicator (Not an employee of operation) 4 Other, (Specify:________________)
	6					7				8					9			10	11	12
L I N E	How much area was treated?					What was the total amount applied per application?				How much was applied per acre OR per 1,000 square feet per application?					UNIT [Enter code from above.] CODE			How many times was this applied? NUMBER	How was this product applied? [Enter code from above. CODE	Who made the application(s)? [Enter code from above.] CODE
	ACRES		OR		SQUARE FEET					RATE PER ACRE		OR	RATE PER 1,000 SQUARE FEET
42	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
43	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
44	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
45	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
46	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
47	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
48	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
49	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
50	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
51	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
52	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
53	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
54	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
55	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313

PRODUCTION CATEGORY CODES FOR COLUMN 4													LOCATION CODES FOR COLUMN 5
NURSERY 1 Transplants for commercial vegetable and strawberry production 2 Propagative nursery material or lining-out stock 3 Broadleaf evergreens 4 Coniferous evergreens 5 Deciduous shade trees 6 Deciduous flowering trees 7 Deciduous shrubs 8 Fruit and nut plants 9 Christmas trees 10 Palms 11 Ornamental grasses 12 Other woody ornamentals and vines 20 Non-production area					FLORICULTURE 13 Cut flowers 14 Flowering plants (potted) 15 Bedding plants (flat, potted, hanging) 16 Foliage plants (potted or hanging) 17 Propagative floriculture material 18 Cut cultivated greens 19 Herbaceous perennials 20 Non-production area								1 Greenhouse (enclosed) 2 Shade Structure (frames, slat, saran, cloth, screen, non-enclosed greenhouse, etc.) 3 Natural Shade Area (palm, citrus, etc.) 4 In The Open Production Area 5 Perimeter (non-production areas)
				1				2	3					4			5
CHEMICAL PRODUCT NAME			L I N E	What products were applied? [Enter product code.]				Was this product bought in liquid or dry form? [Enter L or D.]	Was this part of a tank mix? [If tank mix, enter line number of first product in mix.]					What was this chemical mostly applied to? [Enter code from above.] CODE			Where was this product mostly applied? [Enter code from above.] CODE
			56	301					302					303			304
			57	301					302					303			304
			58	301					302					303			304
			59	301					302					303			304
			60	301					302					303			304
			61	301					302					303			304
			62	301					302					303			304
			63	301					302					303			304
			64	301					302					303			304
			65	301					302					303			304
			66	301					302					303			304
			67	301					302					303			304
			68	301					302					303			304
			69	301					302					303			304
[For pesticides not listed in Respondent Booklet, specify---]
Line No.		Pesticide Type (Herbicide, Insecticide, Fungicide, etc.)					Tradename and Formulation					Form Purchased (Liquid or Dry)				EPA No.
_____________		__________________________					____________________________					________________				_________________
_____________		__________________________					____________________________					________________				_________________
_____________		__________________________					____________________________					________________				_________________

UNIT CODES FOR COLUMN 9									METHOD CODES FOR COLUMN 11								APPLICATOR CODES FOR COLUMN 12
1 Pounds 12 Gallons 13 Quarts 14 Pints 15 Liquid Ounces 20 Teaspoons 21 Tablespoons				28 Dry Ounces 30 Grams 40 Kilograms 41 Liters 42 Milliliters 50 Other, bags, WSP, etc. (Specify unit & weight________)					1 Hand held back pack sprayer 2 Hand held wand/gun/boom from power hydraulic sprayers 3 Hand held granular shakers 4 Hand held granular rotary applicator (whirly bird, belly grinder) 5 Hand held foggers 6 Dusting 7 Overhead rail sprayers (track sprayers) 8 Root ball/container/cutting/flower dip 9 Drench 10 Stationary fogger, aerosols, misters, electrostatic sprayers, smokers 11 Tractor powered boom sprayer 12 Tractor powered air blast or mister 13 Aerial application 14 Chemigation 15 Machine injection, branded, broadcast, knifed in 16 Other, (Specify____________________)								1 Licensed operator/employee pesticide applicator 2 Unlicensed operator/employee under the direction of licensed applicator 3 Hired custom applicator (Not an employee of operation) 4 Other, (Specify:________________)
	6					7				8					9			10	11	12
L I N E	How much area was treated?					What was the total amount applied per application?				How much was applied per acre OR per 1,000 square feet per application?					UNIT [Enter code from above.] CODE			How many times was this applied? NUMBER	How was this product applied? [Enter code from above. CODE	Who made the application(s)? [Enter code from above.] CODE
	ACRES		OR		SQUARE FEET					RATE PER ACRE		OR	RATE PER 1,000 SQUARE FEET
56	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
57	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
58	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
59	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
60	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
61	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
62	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
63	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
64	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
65	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
66	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
67	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
68	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
69	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313

PRODUCTION CATEGORY CODES FOR COLUMN 4													LOCATION CODES FOR COLUMN 5
NURSERY 1 Transplants for commercial vegetable and strawberry production 2 Propagative nursery material or lining-out stock 3 Broadleaf evergreens 4 Coniferous evergreens 5 Deciduous shade trees 6 Deciduous flowering trees 7 Deciduous shrubs 8 Fruit and nut plants 9 Christmas trees 10 Palms 11 Ornamental grasses 12 Other woody ornamentals and vines 20 Non-production area						FLORICULTURE 13 Cut flowers 14 Flowering plants (potted) 15 Bedding plants (flat, potted, hanging) 16 Foliage plants (potted or hanging) 17 Propagative floriculture material 18 Cut cultivated greens 19 Herbaceous perennials 20 Non-production area							1 Greenhouse (enclosed) 2 Shade Structure (frames, slat, saran, cloth, screen, non-enclosed greenhouse, etc.) 3 Natural Shade Area (palm, citrus, etc.) 4 In The Open Production Area 5 Perimeter (non-production areas)
				1				2	3					4			5
CHEMICAL PRODUCT NAME			L I N E	What products were applied? [Enter product code.]				Was this product bought in liquid or dry form? [Enter L or D.]	Was this part of a tank mix? [If tank mix, enter line number of first product in mix.]					What was this chemical mostly applied to? [Enter code from above.] CODE			Where was this product mostly applied? [Enter code from above.] CODE
			70	301					302					303			304
			71	301					302					303			304
			72	301					302					303			304
			73	301					302					303			304
			74	301					302					303			304
			75	301					302					303			304
			76	301					302					303			304
			77	301					302					303			304
			78	301					302					303			304
			79	301					302					303			304
			80	301					302					303			304
			81	301					302					303			304
			82	301					302					303			304
			83	301					302					303			304
[For pesticides not listed in Respondent Booklet, specify---]
Line No.		Pesticide Type (Herbicide, Insecticide, Fungicide, etc.)					Tradename and Formulation					Form Purchased (Liquid or Dry)				EPA No.
_____________		__________________________					____________________________					________________				_________________
_____________		__________________________					____________________________					________________				_________________
_____________		__________________________					____________________________					________________				_________________

UNIT CODES FOR COLUMN 9									METHOD CODES FOR COLUMN 11								APPLICATOR CODES FOR COLUMN 12
1 Pounds 12 Gallons 13 Quarts 14 Pints 15 Liquid Ounces 20 Teaspoons 21 Tablespoons				28 Dry Ounces 30 Grams 40 Kilograms 41 Liters 42 Milliliters 50 Other, bags, WSP, etc. (Specify unit & weight________)					1 Hand held back pack sprayer 2 Hand held wand/gun/boom from power hydraulic sprayers 3 Hand held granular shakers 4 Hand held granular rotary applicator (whirly bird, belly grinder) 5 Hand held foggers 6 Dusting 7 Overhead rail sprayers (track sprayers) 8 Root ball/container/cutting/flower dip 9 Drench 10 Stationary fogger, aerosols, misters, electrostatic sprayers, smokers 11 Tractor powered boom sprayer 12 Tractor powered air blast or mister 13 Aerial application 14 Chemigation 15 Machine injection, branded, broadcast, knifed in 16 Other, (Specify____________________)								1 Licensed operator/employee pesticide applicator 2 Unlicensed operator/employee under the direction of licensed applicator 3 Hired custom applicator (Not an employee of operation) 4 Other, (Specify:________________)
	6					7				8					9			10	11	12
L I N E	How much area was treated?					What was the total amount applied per application?				How much was applied per acre OR per 1,000 square feet per application?					UNIT [Enter code from above.] CODE			How many times was this applied? NUMBER	How was this product applied? [Enter code from above. CODE	Who made the application(s)? [Enter code from above.] CODE
	ACRES		OR		SQUARE FEET					RATE PER ACRE		OR	RATE PER 1,000 SQUARE FEET
70	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
71	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
72	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
73	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
74	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
75	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
76	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
77	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
78	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
79	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
80	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
81	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
82	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
83	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313

PRODUCTION CATEGORY CODES FOR COLUMN 4													LOCATION CODES FOR COLUMN 5
NURSERY 1 Transplants for commercial vegetable and strawberry production 2 Propagative nursery material or lining-out stock 3 Broadleaf evergreens 4 Coniferous evergreens 5 Deciduous shade trees 6 Deciduous flowering trees 7 Deciduous shrubs 8 Fruit and nut plants 9 Christmas trees 10 Palms 11 Ornamental grasses 12 Other woody ornamentals and vines 20 Non-production area					FLORICULTURE 13 Cut flowers 14 Flowering plants (potted) 15 Bedding plants (flat, potted, hanging) 16 Foliage plants (potted or hanging) 17 Propagative floriculture material 18 Cut cultivated greens 19 Herbaceous perennials 20 Non-production area								1 Greenhouse (enclosed) 2 Shade Structure (frames, slat, saran, cloth, screen, non-enclosed greenhouse, etc.) 3 Natural Shade Area (palm, citrus, etc.) 4 In The Open Production Area 5 Perimeter (non-production areas)
				1				2	3					4			5
CHEMICAL PRODUCT NAME			L I N E	What products were applied? [Enter product code.]				Was this product bought in liquid or dry form? [Enter L or D.]	Was this part of a tank mix? [If tank mix, enter line number of first product in mix.]					What was this chemical mostly applied to? [Enter code from above.] CODE			Where was this product mostly applied? [Enter code from above.] CODE
			84	301					302					303			304
			85	301					302					303			304
			86	301					302					303			304
			87	301					302					303			304
			88	301					302					303			304
			89	301					302					303			304
			90	301					302					303			304
			91	301					302					303			304
			92	301					302					303			304
			93	301					302					303			304
			94	301					302					303			304
			95	301					302					303			304
			96	301					302					303			304
[For pesticides not listed in Respondent Booklet, specify---]
Line No.		Pesticide Type (Herbicide, Insecticide, Fungicide, etc.)					Tradename and Formulation					Form Purchased (Liquid or Dry)				EPA No.
_____________		__________________________					____________________________					________________				_________________
_____________		__________________________					____________________________					________________				_________________
_____________		__________________________					____________________________					________________				_________________

UNIT CODES FOR COLUMN 9									METHOD CODES FOR COLUMN 11								APPLICATOR CODES FOR COLUMN 12
1 Pounds 12 Gallons 13 Quarts 14 Pints 15 Liquid Ounces 20 Teaspoons 21 Tablespoons				28 Dry Ounces 30 Grams 40 Kilograms 41 Liters 42 Milliliters 50 Other, bags, WSP, etc. (Specify unit & weight________)					1 Hand held back pack sprayer 2 Hand held wand/gun/boom from power hydraulic sprayers 3 Hand held granular shakers 4 Hand held granular rotary applicator (whirly bird, belly grinder) 5 Hand held foggers 6 Dusting 7 Overhead rail sprayers (track sprayers) 8 Root ball/container/cutting/flower dip 9 Drench 10 Stationary fogger, aerosols, misters, electrostatic sprayers, smokers 11 Tractor powered boom sprayer 12 Tractor powered air blast or mister 13 Aerial application 14 Chemigation 15 Machine injection, branded, broadcast, knifed in 16 Other, (Specify____________________)								1 Licensed operator/employee pesticide applicator 2 Unlicensed operator/employee under the direction of licensed applicator 3 Hired custom applicator (Not an employee of operation) 4 Other, (Specify:________________)
	6					7				8					9			10	11	12
L I N E	How much area was treated?					What was the total amount applied per application?				How much was applied per acre OR per 1,000 square feet per application?					UNIT [Enter code from above.] CODE			How many times was this applied? NUMBER	How was this product applied? [Enter code from above. CODE	Who made the application(s)? [Enter code from above.] CODE
	ACRES		OR		SQUARE FEET					RATE PER ACRE		OR	RATE PER 1,000 SQUARE FEET
84	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
85	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
86	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
87	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
88	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
89	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
90	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
91	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
92	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
93	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
94	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
95	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313
96	305	.___			306	307	.___			308	.___ ___		309	.___ ___	310			311	312	313