Form DPR-ENF-228 "Post-application Summary (Field Fumigation)" - California

What Is Form DPR-ENF-228?

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 December 1, 2012;
  • 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-ENF-228 by clicking the link below or browse more documents and templates provided by the California Department of Pesticide Regulation.

ADVERTISEMENT
ADVERTISEMENT

Download Form DPR-ENF-228 "Post-application Summary (Field Fumigation)" - California

Download PDF

Fill PDF online

Rate (4.6 / 5) 44 votes
State of California
Department of Pesticide Regulation
Enforcement Branch
POST-APPLICATION SUMMARY (FIELD FUMIGATION)
ATTACHMENT #
DPR-ENF-228 (Est. 12/12)
-- Attach to Fumigant Management Plan (FMP) --
Page 1 of 2
PAGE
OF
A. General Application Information
DATE OF APPLICATION
TIME OF APPLICATION
PERMIT NUMBER
SITE IDENTIFICATION NUMBER
APPLICATION RATE
APPLICATION BLOCK SIZE
B. Weather Conditions
SUMMARY OF THE NATIONAL WEATHER SERVICE WEATHER FORECAST (INCLUDING WIND SPEED AND AIR STAGNATION ADVISIORIES, IF APPLICABLE) DURING THE APPLICATION AND THE
48 HOURS AFTER THE APPLICATION IS COMPLETE. A PRINTED COPY MAY BE ATTACHED TO THE POST-APPLICATION SUMMARY.
CHECK HERE IF PRINTED COPY IS ATTACHED TO THE POST-APPLICATION SUMMARY
IF PRINTED COPY IS NOT ATTACHED, THEN COMPLETE THIS SECTION:
NATIONAL WEATHER SERVICE WEATHER FORECAST
WIND SPEED
AIR-STAGNATION ADVISORIES
C. Tarp Perforation / Removal - Tarp Used
YES
NO
PERSON RESPONSIBLE FOR CUTTING TARP
TARP CUTTING METHOD
DATE OF TARP CUTTING
TIME OF TARP CUTTING
TARP REMOVAL METHOD
DATE OF TARP REMOVAL
TIME OF TARP REMOVAL
PERSON RESPONSIBLE FOR TARP REMOVAL
CONDITIONS THAT CAUSED EARLY PERFORATION AND/OR REMOVAL OF TARPS
Tarp Repair
YES
NO
LOCATION AND SIZE OF TARP DAMAGE
DATE OF TARP DAMAGE DISCOVERY
DATE AND TIME OF TARP REPAIR(S)
DESCRIPTION OF ANY TARP / TARP SEAL / TARP EQUIPMENT FAILURE
(Over)
State of California
Department of Pesticide Regulation
Enforcement Branch
POST-APPLICATION SUMMARY (FIELD FUMIGATION)
ATTACHMENT #
DPR-ENF-228 (Est. 12/12)
-- Attach to Fumigant Management Plan (FMP) --
Page 1 of 2
PAGE
OF
A. General Application Information
DATE OF APPLICATION
TIME OF APPLICATION
PERMIT NUMBER
SITE IDENTIFICATION NUMBER
APPLICATION RATE
APPLICATION BLOCK SIZE
B. Weather Conditions
SUMMARY OF THE NATIONAL WEATHER SERVICE WEATHER FORECAST (INCLUDING WIND SPEED AND AIR STAGNATION ADVISIORIES, IF APPLICABLE) DURING THE APPLICATION AND THE
48 HOURS AFTER THE APPLICATION IS COMPLETE. A PRINTED COPY MAY BE ATTACHED TO THE POST-APPLICATION SUMMARY.
CHECK HERE IF PRINTED COPY IS ATTACHED TO THE POST-APPLICATION SUMMARY
IF PRINTED COPY IS NOT ATTACHED, THEN COMPLETE THIS SECTION:
NATIONAL WEATHER SERVICE WEATHER FORECAST
WIND SPEED
AIR-STAGNATION ADVISORIES
C. Tarp Perforation / Removal - Tarp Used
YES
NO
PERSON RESPONSIBLE FOR CUTTING TARP
TARP CUTTING METHOD
DATE OF TARP CUTTING
TIME OF TARP CUTTING
TARP REMOVAL METHOD
DATE OF TARP REMOVAL
TIME OF TARP REMOVAL
PERSON RESPONSIBLE FOR TARP REMOVAL
CONDITIONS THAT CAUSED EARLY PERFORATION AND/OR REMOVAL OF TARPS
Tarp Repair
YES
NO
LOCATION AND SIZE OF TARP DAMAGE
DATE OF TARP DAMAGE DISCOVERY
DATE AND TIME OF TARP REPAIR(S)
DESCRIPTION OF ANY TARP / TARP SEAL / TARP EQUIPMENT FAILURE
(Over)
POST-APPLICATION SUMMARY (FIELD FUMIGATION)
DPR-ENF-228 (Est. 12/12)
Page 2 of 2
PAGE
OF
D. Application Air Monitoring Results
WAS AIR MONITORING CONDUCTED WITHIN THE APPLICATION BLOCK?
Y ES
NO
WAS SENSORY IRRITATION EXPERIENCED BY A HANDLER?
LOCATION WHERE IRRITATION EXPERIENCED
YES
NO
DATE AND TIME
HANDLER TASK / ACTIVITY
ACTION TAKEN
WAS DIRECT-READ INSTRUMENT USED FOR AIR MONITORING? IF YES, ATTACH AIR MONITORING RESULTS REQUIRED BY LABELING.
YES (Type used)
NO
E. Drip Application Monitoring Results
WAS THIS A DRIP IRRIGATION APPLICATION? IF YES, ATTACH DRIP APPLICATION MONITORING RESULTS REQUIRED BY LABELING.
YES
NO
F. Posting
TREATED AREA SIGNS REMOVED BY
DATE OF TREATED AREA SIGN REMOVAL
BUFFER ZONE SIGNS REMOVED BY
DATE OF BUFFER ZONE SIGN REMOVAL
G. Deviations from the Fumigant Management Plan
YES
NO
PROVIDE DESCRIPTION OF DEVIATIONS
H. Incidents
YES
NO
DESCRIPTION OF INCIDENTS, EQUIPMENT FAILURE, OR OTHER EMERGENCY AND RESPONSE
I. Complaints - Complaints Received
YES
NO
TYPE OF PERSON FILING COMPLAINT (e.g., On-site handler, bystander)
NAME (If bystander)
BYSTANDER'S ADDRESS (Number and Street, City, State, ZIP Code)
BYSTANDER'S TELEPHONE NUMBER (Include Area Code)
DESCRIPTION OF CONTROL MEASURES OR EMERGENCY PROCEDURES TAKEN (Continued)
J. Attachments (List ALL Attachments)
POST-APPLICATION WATER TREATMENTS
MONITORING DURING APPLICATION
MONITORING POST-APPLICATION
AIR MONIT
OR
ING
WEATHER FORECAST
DRIP IRRIGATION MONITORING INFORMATION
OTHER
I verify that the information provided in this Post-Application Summary and its attachments accurately reflect the actual conditions associated
with this application. I certify that I will maintain this record and make it available for inspection for two years from the date of the application.
SIGNATURE OF CERTIFIED APPLICATOR SUPERVISING APPLICATION
DATE
Page of 2