QID Grape and Almond Acreage Survey - Parcel Printout

PRINTED - ??/??/????

SEQUENCE - ??????? ARE THERE ANY CHANGES TO THIS PARCEL? YES_____ NO _____ PARCEL PAGE - ??

(CHECK APPROPRIATE CHOICE)

ALMOND, AND GRAPE ACREAGE SURVEY COUNTY - ????/????????

PARCEL - ???

NUMBER - ???

OPERATOR ??????? OD ?? PS ?? AS?? OWNER ??????? OD ?? PS ?? AS??

NAME NAME

ADDRESS 1 ADDRESS 1

CITY/STATE/ZIP CITY/STATE/ZIP

PHONE PHONE

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SEC | TWP | RNG | PARCEL NAME | APN | PARCEL ACRES | CD

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??? ??? ??? Operator given name ???? ???.? ??

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APN4 COUNTY AG COMMISSIONER’S ACTIVITY

PARCEL LOCATION PESTICIDE PERMIT NUMBER: ??????? ??????

????????????????????????????????

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|BK|SB|CRP|VAR| CROP NAME | VARIETY NAME |YEAR|SYS|SPACING|TREE/VINE| ACRES |ABAN|OM|

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ARE THERE ANY NEW OR ADDITIONAL PLANTINGS ON THIS PARCEL? YES___ NO___ - IF YES, SPECIFY ABOVE

DID YOU PULL ANY TREES OR VINES FROM THIS PARCEL? YES___ NO___ - IF YES, SPECIFY ABOVE

OMB Control Number 0535-0039 Expiration Date: XX/XX/XXXX