Follow the steps to accurately complete the form.

1. Click the ‘Get Form’ button to access the form and open it for editing.
2. Fill in the 'Licensed Applicator' field with the name of the certified individual responsible for the pesticide application.
3. If applicable, enter the name of the trained serviceperson in the 'Trained Serviceperson' field.
4. In the 'Customer Name & Address' section, provide the full name and address of the customer receiving the service.
5. Record the date of application in the designated field.
6. Describe the 'Location of Treated Area' in detail, specifying where the pesticide was applied.
7. Indicate the type and size of the treated area, ensuring clarity for future reference.
8. In the 'Product & Registration #' section, list each pesticide product used along with its corresponding registration number.
9. Provide the product brand name and EPA registration number in the following field.
10. Enter the total amount of each product used during the application.
11. If any products were diluted, record the total volume of the diluted mixture.
12. Specify the equipment used for the application in the applicable field, including details such as the manufacturer and model for types like Spreader, Hand Can, Hand Gun, or Boom Sprayer.
13. Document the start and end time of the pesticide application.
14. Lastly, indicate the wind direction and speed, as well as the temperature during the application.
15. After filling out all sections, make sure to save your changes, and you may choose to download, print, or share the completed form.

Complete your documentation easily by filling out the form online now.