Form DPR-REG-028B "Experimental Pesticide Use Report (Continued)" - California

What Is Form DPR-REG-028B?

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 April 1, 2015;
  • 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 printable version of Form DPR-REG-028B 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-REG-028B "Experimental Pesticide Use Report (Continued)" - California

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State of California
Authorization Number
Department of Pesticide Regulation
Experimental Pesticide Use Report
DPR-REG-028b (Est. 4/15)
NOTE: Use as many pages as you need. Refer to DPR-REG-28a for instructions.
Experimental Pesticide Use Report (Continued)
Use Data
2. Product Name
3. Formulation
4. Area or
5. Commodity or
6. Crop
7. County Where Trial Was
(only one)
Units Treated
Site Treated
Disposition
Conducted (only one)
(only one)
8. Active Ingredient(s)
9. Total Lbs. AI Used
2. Product Name
3. Formulation
4. Area or
5. Commodity or
6. Crop
7. County Where Trial Was
(only one)
Units Treated
Site Treated
Disposition
Conducted (only one)
(only one)
8. Active Ingredient(s)
9. Total Lbs. AI Used
2. Product Name
3. Formulation
4. Area or
5. Commodity or
6. Crop
7. County Where Trial Was
(only one)
Units Treated
Site Treated
Disposition
Conducted (only one)
(only one)
8. Active Ingredient(s)
9. Total Lbs. AI Used
2. Product Name
3. Formulation
4. Area or
5. Commodity or
6. Crop
7. County Where Trial Was
(only one)
Units Treated
Site Treated
Disposition
Conducted (only one)
(only one)
8. Active Ingredient(s)
9. Total Lbs. AI Used
2. Product Name
3. Formulation
4. Area or
5. Commodity or
6. Crop
7. County Where Trial Was
(only one)
Units Treated
Site Treated
Disposition
Conducted (only one)
(only one)
8. Active Ingredient(s)
9. Total Lbs. AI Used
I certify that all the information contained within this form is true and complete to the best of my knowledge.
10. Signature of Researcher
Title
Date
Page ___ of ___
State of California
Authorization Number
Department of Pesticide Regulation
Experimental Pesticide Use Report
DPR-REG-028b (Est. 4/15)
NOTE: Use as many pages as you need. Refer to DPR-REG-28a for instructions.
Experimental Pesticide Use Report (Continued)
Use Data
2. Product Name
3. Formulation
4. Area or
5. Commodity or
6. Crop
7. County Where Trial Was
(only one)
Units Treated
Site Treated
Disposition
Conducted (only one)
(only one)
8. Active Ingredient(s)
9. Total Lbs. AI Used
2. Product Name
3. Formulation
4. Area or
5. Commodity or
6. Crop
7. County Where Trial Was
(only one)
Units Treated
Site Treated
Disposition
Conducted (only one)
(only one)
8. Active Ingredient(s)
9. Total Lbs. AI Used
2. Product Name
3. Formulation
4. Area or
5. Commodity or
6. Crop
7. County Where Trial Was
(only one)
Units Treated
Site Treated
Disposition
Conducted (only one)
(only one)
8. Active Ingredient(s)
9. Total Lbs. AI Used
2. Product Name
3. Formulation
4. Area or
5. Commodity or
6. Crop
7. County Where Trial Was
(only one)
Units Treated
Site Treated
Disposition
Conducted (only one)
(only one)
8. Active Ingredient(s)
9. Total Lbs. AI Used
2. Product Name
3. Formulation
4. Area or
5. Commodity or
6. Crop
7. County Where Trial Was
(only one)
Units Treated
Site Treated
Disposition
Conducted (only one)
(only one)
8. Active Ingredient(s)
9. Total Lbs. AI Used
I certify that all the information contained within this form is true and complete to the best of my knowledge.
10. Signature of Researcher
Title
Date
Page ___ of ___