Form DPR-197 "Forms Requisition" - California

What Is Form DPR-197?

This is a legal form that was released by the California Department of Pesticide Regulation - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 1, 2018;
  • The latest edition provided by the California Department of Pesticide Regulation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DPR-197 by clicking the link below or browse more documents and templates provided by the California Department of Pesticide Regulation.

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Download Form DPR-197 "Forms Requisition" - California

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State of California
Department of Pesticide Regulation
FORMS REQUISITION
DPR-197 (Rev. 2/18)
Page 1 of 3
COUNTY: _________________________________________
PHONE NO.: __________________________________
ORDERED BY: _____________________________________
FAX NO.: _____________________________________
ADDRESS: _________________________________________
NO. OF PAGES: ________________________________
_________________________________________
DATE ORDERED: ______________________________
Please allow two weeks for processing your forms order after receipt. You may fax (916) 445-6845; mail (Department
of Pesticide Regulation, Attn: CAC Forms Coordinator, P.O. Box 4015, Sacramento, CA 95812-4015); or e-mail your
requisition to the CAC Forms Coordinator <formscoordinator@cdpr.ca.gov>. In order to accurately track orders, all
form orders must be submitted in writing; no orders will be taken over the telephone. Enforcement forms are available
for download at http://cdpr.ca.gov/docs/enforce/prenffrm/prenfmnu.htm. If you have any questions regarding this
requisition, please contact the CAC Forms Coordinator at <formscoordinator@cdpr.ca.gov>.
DEPARTMENT OF PESTICIDE REGULATION (DPR)
FORM NUMBER
FORM NAME
QUANTITY
DPR-071
Clothing Release Form / Formulario para Entregar la Ropa (Est. 07/05)
_________
DPR-161
Decision Report (Rev. 08/07)
_________
DPR-161A
Decision Report Supplemental (Rev. 08/07)
_________
DPR-197
Forms Requisition (Rev. 2/18)
_________
ENFORCEMENT
FORM NUMBER
FORM NAME
QUANTITY
PR-ENF-016
Operator Identification Number Application (Rev. 09/09) 25/pad
_________
PR-ENF-100A
Statement (Est. 03/94) 50/pad
_________
PR-ENF-100B
Statement Continuation (Est. 03/94) 50/pad
_________
PR-ENF-125
Application – Restricted Materials Permit (Rev. 11/07) 25/pad
_________
PR-ENF-125A
Application – Restricted Materials Permit – Supplement (Rev. 10/07) 25/pad
_________
PR-ENF-126
Notice of Intent to Apply Restricted Materials (Rev. 11/07) 25/pad
_________
PR-ENF-126X
Notice of Intent and Pesticide Use Report – Combination (Rev. 11/07) 25/pad
_________
DPR-ENF-133
Medical Information Authorization (Rev. 07/13) 25/pad
_________
DPR-ENF-133X
Autorización de Información Médica (Rev. 07/13) 25/pad
_________
State of California
Department of Pesticide Regulation
FORMS REQUISITION
DPR-197 (Rev. 2/18)
Page 1 of 3
COUNTY: _________________________________________
PHONE NO.: __________________________________
ORDERED BY: _____________________________________
FAX NO.: _____________________________________
ADDRESS: _________________________________________
NO. OF PAGES: ________________________________
_________________________________________
DATE ORDERED: ______________________________
Please allow two weeks for processing your forms order after receipt. You may fax (916) 445-6845; mail (Department
of Pesticide Regulation, Attn: CAC Forms Coordinator, P.O. Box 4015, Sacramento, CA 95812-4015); or e-mail your
requisition to the CAC Forms Coordinator <formscoordinator@cdpr.ca.gov>. In order to accurately track orders, all
form orders must be submitted in writing; no orders will be taken over the telephone. Enforcement forms are available
for download at http://cdpr.ca.gov/docs/enforce/prenffrm/prenfmnu.htm. If you have any questions regarding this
requisition, please contact the CAC Forms Coordinator at <formscoordinator@cdpr.ca.gov>.
DEPARTMENT OF PESTICIDE REGULATION (DPR)
FORM NUMBER
FORM NAME
QUANTITY
DPR-071
Clothing Release Form / Formulario para Entregar la Ropa (Est. 07/05)
_________
DPR-161
Decision Report (Rev. 08/07)
_________
DPR-161A
Decision Report Supplemental (Rev. 08/07)
_________
DPR-197
Forms Requisition (Rev. 2/18)
_________
ENFORCEMENT
FORM NUMBER
FORM NAME
QUANTITY
PR-ENF-016
Operator Identification Number Application (Rev. 09/09) 25/pad
_________
PR-ENF-100A
Statement (Est. 03/94) 50/pad
_________
PR-ENF-100B
Statement Continuation (Est. 03/94) 50/pad
_________
PR-ENF-125
Application – Restricted Materials Permit (Rev. 11/07) 25/pad
_________
PR-ENF-125A
Application – Restricted Materials Permit – Supplement (Rev. 10/07) 25/pad
_________
PR-ENF-126
Notice of Intent to Apply Restricted Materials (Rev. 11/07) 25/pad
_________
PR-ENF-126X
Notice of Intent and Pesticide Use Report – Combination (Rev. 11/07) 25/pad
_________
DPR-ENF-133
Medical Information Authorization (Rev. 07/13) 25/pad
_________
DPR-ENF-133X
Autorización de Información Médica (Rev. 07/13) 25/pad
_________
State of California
Department of Pesticide Regulation
FORMS REQUISITION
DPR-197 (Rev. 2/18)
Page 2 of 3
PEST MANAGEMENT AND LICENSING (PR-PML)
FORM NUMBER
FORM NAME
QUANTITY
PR-PML-001A-WR
Qualified Applicator Certificate County Agricultural Commissioner Staff
Waiver Request (Est. 10/03) 50/pad
_________
DPR-PML-017C
Production Agriculture Monthly Pesticide Use Report (Rev.8/15) 25/pad
_________
DPR-PML-025
Pesticide Use Report (Rev. 8/15) 25/pad
_________
PR-PML-045
Private Applicator Certificate Application (Rev. 12/04) 50/pad
_________
DPR-PML-060
Monthly Summary Pesticide Use Report (Rev.1/18) 25/pad
_________
PR-PML-179
County Agricultural Commissioner’s Staff Continuing Education Record
(Rev. 09/02) 50/pad
_________
DPR-PML-183
Production Agriculture Monthly Use Report: Multiple Site/Community
(Rev. 08/15) 25/pad
_________
(N/A)
Private Applicator Certificate Cards (Tan) 8/sheet
_________
New or Renew
To ensure individuals use the most recent version, forms for a new DPR license or
License/Certificate
certificate or forms for renewals can be found on DPR’s web site at:
Applications
http://www.cdpr.ca.gov/docs/license/lcforms.htm
Scantron Sheets
F-158 (500/pkg)
_________
State of California
Department of Pesticide Regulation
FORMS REQUISITION
DPR-197 (Rev. 2/18)
Page 3 of 3
WORKER HEALTH AND SAFETY (HS)
(N/A)
Glove Category Selection Key Wallet Cards (50)
_________
Pesticide Safety Information Series (PSIS) A-1 through A-10
Series Number
No. of Copies (English)
No. of Copies (Spanish)
No. of Copies (Punjabi)
A Series Index (9/15) HS-641A___________
HS-641A(S)_________
HS-641A(P)_______
A-1 (Rev. 06/17)
HS-002_____________
HS-002(S)___________
HS-002(P)_________
A-2 (Rev. 06/17)
HS-711_____________
HS-711(S)___________
HS-711(P)_________
A-3 (Rev. 06/17)
HS-713_____________
HS-713(S)___________
HS-713(P)_________
A-4 (Rev. 06/17)
HS-716_____________
HS-716(S)___________
HS-716(P)_________
A-5 (Rev. 06/17)
HS-632_____________
HS-632(S)___________
HS-632(P)_________
A-6 (Rev. 06/17)
HS-1697____________
HS-1697(S)__________
HS-1697(P)________
A-7 (Rev. 06/17)
HS-1228____________
HS-1228(S)__________
HS-1228(P)________
A-8 (Rev. 06/17)
HS-1571____________
HS-1571(S)__________
HS-1571(P)________
A-9 (Rev. 06/17)
HS-1587____________
HS-1587(S)__________
HS-1587(P)________
A-10 (Rev. 06/17)
HS-8_______________
HS-8(S)_____________
HS-8(P)___________
Pesticide Safety Information Series (PSIS) N-1 through N-8
Series Number
No. of Copies (English)
No. of Copies (Spanish)
No. of Copies (Punjabi)
N Series Index (9/15) HS-641N___________
HS-641N(S)_________
HS-641N(P)_______
N-1 (Rev. 06/17)
HS-1742____________
HS-1742(S)__________
HS-1742(P)________
N-2 (Rev. 06/17)
HS-1743____________
HS-1743(S)__________
HS-1743(P)________
N-3 (Rev. 06/17)
HS-1744____________
HS-1744(S)__________
HS-1744(P)________
N-4 (Rev. 06/17)
HS-1745____________
HS-1745(S)__________
HS-1745(P)________
N-5 (Rev. 06/17)
HS-1746____________
HS-1746(S)__________
HS-1746(P)________
N-6 (Rev. 06/17)
HS-1759____________
HS-1759(S)__________
HS-1759(P)________
N-7 (Rev. 06/17)
HS-1748____________
HS-1748(S)__________
HS-1748(P)________
N-8 (Rev. 06/17)
HS-1749____________
HS-1749(S)__________
HS-1749(P)________
Page of 3