Form APHIS 2060 APHIS 2060 Environmental Monitoring Form

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0579-0117. The time
required to complete this information collection is estimated to average .5 hours per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

ENVIRONMENTAL
MONITORING FORM

UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
Program/Project

1.

7.

2.

State

County

3.

8.

Sample Description
and Number

Site Identification

4.

9.

5.

Date Collected

10.

Location
DISTANCE (Ft.)

OMB APPROVED
0579 –0117
EXP: XX/XXXX
SERIAL NUMBER

6.

Time Collected

11.

Pesticide

12.

Formulation

Application
METHOD

DIRECTION

Sample Type

RATE

Priority
Routine
13.

Dates Treatment Applied
1
Month

14.

2
Day

Month

15.

Total
Treatments

3
Day

Month

4
Day

Month

16.

Time of Last
Treatment

5
Day

Month

6
Day

17.

Soil Type (from county soil survey)

7
Day

Month

18.

8
Day

Month

19.

Land Slope
(Degrees)

21.

Month

20.

Last Rainfall
MONTH

DAY

Wind
AMT

SPEED

DIRECTION

22.

Water
Size
(Acres or Width)

Depth
(Feet)

Velocity
(Ft/Min.)

Temp.

(°F)

pH
(include decimal pt.)
Before
After

Dissolved
Oxygen
(mg/L)

Average Air
Temp.
(°F)

24.
25.

Latitude
Longitude
Remarks (e.g. Sketch of site, unusual occurrences, and additional information unique to sample, etc.)

Name of Collector (type or print)

26.

27.

Initials

28.

Telephone Number of Collector

FOR LABORATORY USE ONLY
29.

32.

Date Sample Received

Laboratory Accession Number

APHIS FORM 2060
OCT 2011

30.

33.

Rel.
Hum.

23.

Water Body
Type
(Pool, Pond, Reservoir, Well, Stream, etc.)

Day

Date Analyzed

Condition of Sample on Receipt

(Replaces APHIS Form 2060 (OCT 99) which is obsolete)

31.

Results

Guidelines
Every sample must be accompanied by a completed APHIS Form 2060. The present guidelines are generic and will be superseded by
specific instructions included in an Environmental Monitoring Plan for a particular program or operation. If you have any questions about
how to fill out the form, or any other questions about monitoring, please call the PPQ Environmental Compliance Team at 301-734-7592
or 301-734-8876.
1. Program/Project: Pest program name or acronym and the project or treatment name.
2. State: The two letter postal abbreviation of the state in which the sample was collected.
3. County: The County in which the sample was collected.
4. Site Identification: Assign a number which uniquely identifies the site (can be alphanumeric).
5. Date Collected: The date that the sample was collected.
6. Time Collected: The time the sample was collected, using a 24-hour clock.
7. Sample Description and Number: Sample media (e.g., soil, water, dye card, neat pesticide, tank mix) and a numerical identifier.
8. Location: The distance (in feet) and direction from the nearest point of the treatment block to the specific location where the sample
was collected. (i.e., 500 SE defines a sample location 500 feet southeast of the treatment block).
9. Pesticide: The name of the pesticide for which the laboratory should analyze. If analyses for more than one pesticide are necessary,
list the other pesticides in the Remarks block.
10. Formulation: The tank mixture ingredients and proportions of the pesticide formulation (e.g., 1 ounce Diflubenzuron, 10 ounces oil,
and 20 ounces water).
11. Application:
Method: The method used to apply the pesticide (e.g., fixed wing aircraft, ATV, backpack sprayer, drench).
Rate: The rate at which the pesticide is applied (e.g., pounds active ingredient per acre).
12. Sample Type: Check off the appropriate box: Sample types are usually defined as follows:
Priority: Samples collected to respond to any reported or observed adverse impact (e.g., bird kill, fish kill, public health
concern, property damage).
Routine: All samples not considered priority samples.
13. Dates Treatment Applied: The dates treatments applied. If more than 8, then list additional in Remarks block.
14. Total Treatments: Enter the total number of treatments.
15. Time of Last Treatment: The time of day that the last treatment was completed, using a 24-hour clock.
16. Soil Type: Enter the type of soil (e.g., sandy loam).
17. Land Slope: Enter the slope, measured from the treatment block to the sample collection site (positive degrees above horizontal for
an incline or negative degrees below horizontal for a decline)
18. Last Rainfall: The date and amount of the last rainfall before the sample collection.
19. Wind: The speed (mph) and direction from which the wind was coming at the time of the last treatment.
20. Relative Humidity: The relative humidity of the air, measured as a percentage (e.g., 75%) at the time of the last treatment.
21. Water Body:
Type: Examples: pool, lake, river.
Size: Surface area (acres) or width (feet).
22. Water:
Depth: Average depth (feet).
Velocity: At the sample collection site (feet per minute).
Temperature: Water temperature (°F).
pH Values:
Before: The pH of the water sample.
After: If a pH adjustment is required to stabilize the sample, enter the pH of the sample after the adjustment.
Dissolved Oxygen: Enter the oxygen content of the water sample.
23. Average Air Temp.: Enter the air temperature at the time of the last treatment.
24. Latitude and Longitude: Coordinates of sampling site as determined by GPS unit.
25. Remarks: Additional information concerning the location of the sampling site (sketch of the site or attach a map), weather
conditions (additional wind speeds and directions, gusts, cloud cover), circumstances relevant to the results of the sample analysis, and
who to report results to if different from collector.
26. Name of Collector: Print submitter's name.
27. Initials: Submitter's initials in script.
28. Telephone Number of Collector: Include area code.
Distribution
PT 1 - Laboratory: (white copy) – Bundle all original white forms in a water-tight plastic bag inside the sample shipping container, on
top of the samples and ice, and submit to the USDA/APHIS Center for Plant Health Science Technology (CPHST) designated
laboratory.
PT 2 - Environmental Compliance Team: (yellow copy) – Mail to: USDA/APHIS, Plant Protection and Quarantine, 4700 River Road,
Unit 150, Riverdale, MD 20737, along with any attached maps or other documentation.
PT 3 - Collector: (pink copy) – The collector will keep this copy on file for reference.
PT 4 - Submit with Sample: (blue copy) – Package with the individual sample so that if several samples are being shipped in the same
container, each form will be directly associated with its corresponding sample.