Form P-31 "Paraquat Single Purchase Permit Form" - Hawaii

What Is Form P-31?

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

Form Details:

  • Released on August 1, 2005;
  • The latest edition provided by the Hawaii Department of Agriculture;
  • 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 P-31 by clicking the link below or browse more documents and templates provided by the Hawaii Department of Agriculture.

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Download Form P-31 "Paraquat Single Purchase Permit Form" - Hawaii

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P-31
_______________________________________
Firm Name
8/05
State of Hawaii
_________________________________________
Address
DEPARTMENT OF AGRICULTURE
Division of Plant Industry
________________________________________
Date Sold
Pesticides Branch
_______________________________________________
1428 South King Street
Signature of Seller
Honolulu, Hawaii 96814
I understand and certify that the purchase and use of PARAQUAT shall be restricted to the following conditions:
1. The product shall be used only in accordance with the registered label directions.
2. The product shall not be distributed or given to any other person.
3. The product must be stored in a secure place, preferably under lock and key.
4. Any incidents of vandalism, theft, or loss of PARAQUAT must be reported to the Department of Agriculture office immedi-
ately.
5. Empty containers of PARAQUAT shall be triple-rinsed and punctured before disposal.
6. Violators of the above conditions will be subject to a fine of up to a maximum of $25,000.
_________________________________
_________________________________
____________________________
Applicator’s Name
Applicator’s Signature
Certification Number
This form is to be retained by seller and shall be submitted with the sales record to the Department of Agriculture by the 15th of
the following month.
P-31
_______________________________________
Firm Name
8/05
State of Hawaii
_________________________________________
Address
DEPARTMENT OF AGRICULTURE
Division of Plant Industry
________________________________________
Date Sold
Pesticides Branch
_______________________________________________
1428 South King Street
Signature of Seller
Honolulu, Hawaii 96814
I understand and certify that the purchase and use of PARAQUAT shall be restricted to the following conditions:
1. The product shall be used only in accordance with the registered label directions.
2. The product shall not be distributed or given to any other person.
3. The product must be stored in a secure place, preferably under lock and key.
4. Any incidents of vandalism, theft, or loss of PARAQUAT must be reported to the Department of Agriculture office immedi-
ately.
5. Empty containers of PARAQUAT shall be triple-rinsed and punctured before disposal.
6. Violators of the above conditions will be subject to a fine of up to a maximum of $25,000.
_________________________________
_________________________________
____________________________
Applicator’s Name
Applicator’s Signature
Certification Number
This form is to be retained by seller and shall be submitted with the sales record to the Department of Agriculture by the 15th of
the following month.
P-31
_______________________________________
Firm Name
8/05
State of Hawaii
_________________________________________
Address
DEPARTMENT OF AGRICULTURE
Division of Plant Industry
________________________________________
Date Sold
Pesticides Branch
_______________________________________________
1428 South King Street
Signature of Seller
Honolulu, Hawaii 96814
I understand and certify that the purchase and use of PARAQUAT shall be restricted to the following conditions:
1. The product shall be used only in accordance with the registered label directions.
2. The product shall not be distributed or given to any other person.
3. The product must be stored in a secure place, preferably under lock and key.
4. Any incidents of vandalism, theft, or loss of PARAQUAT must be reported to the Department of Agriculture office immedi-
ately.
5. Empty containers of PARAQUAT shall be triple-rinsed and punctured before disposal.
6. Violators of the above conditions will be subject to a fine of up to a maximum of $25,000.
_________________________________
_________________________________
____________________________
Applicator’s Name
Applicator’s Signature
Certification Number
This form is to be retained by seller and shall be submitted with the sales record to the Department of Agriculture by the 15th of
the following month.
P-31
_______________________________________
Firm Name
8/05
State of Hawaii
_________________________________________
Address
DEPARTMENT OF AGRICULTURE
Division of Plant Industry
________________________________________
Date Sold
Pesticides Branch
_______________________________________________
1428 South King Street
Signature of Seller
Honolulu, Hawaii 96814
I understand and certify that the purchase and use of PARAQUAT shall be restricted to the following conditions:
1. The product shall be used only in accordance with the registered label directions.
2. The product shall not be distributed or given to any other person.
3. The product must be stored in a secure place, preferably under lock and key.
4. Any incidents of vandalism, theft, or loss of PARAQUAT must be reported to the Department of Agriculture office immedi-
ately.
5. Empty containers of PARAQUAT shall be triple-rinsed and punctured before disposal.
6. Violators of the above conditions will be subject to a fine of up to a maximum of $25,000.
_________________________________
_________________________________
____________________________
Applicator’s Name
Applicator’s Signature
Certification Number
This form is to be retained by seller and shall be submitted with the sales record to the Department of Agriculture by the 15th of
the following month.