Montana State Laws and Regulations Pertaining to the Use of ...
Montana State Laws and Regulations Pertaining to the Use of ...
Montana State Laws and Regulations Pertaining to the Use of ...
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FORM 1. RESTRICTED USE PESTICIDE SALES RECORDSRESTRICTED USE PESTICIDE SALES RECORDDealer Name:Business Name:City, <strong>State</strong>, Zip:Address:License Number:Date <strong>of</strong>SalePurchaser's NameLicense/Permit No.Purchaser'sAddressPesticidePesticide Trade NameCompanyName EPA Reg. # <strong>and</strong>/or SLN #VolumeSold(lbs or gals)Instructions: This record will satisfy minimum requirements <strong>of</strong> 4.10.504 Administrative Rules <strong>of</strong> <strong>Montana</strong> <strong>and</strong> Title 40 Code <strong>of</strong> Federal <strong>Regulations</strong> 171.12for sales <strong>of</strong> restricted use pesticides. The record must be filled out for each sale <strong>of</strong> a restricted use pesticide. Sales <strong>of</strong> restricted use pesticides shall bemade only <strong>to</strong> certified applica<strong>to</strong>rs in possession <strong>of</strong> valid licenses or permits issued by <strong>the</strong> <strong>Montana</strong> Department <strong>of</strong> Agriculture. Prior <strong>to</strong> making a sale <strong>of</strong> arestricted use pesticide, dealers are required <strong>to</strong> confirm this by viewing <strong>the</strong> purchaser's license or permit. For questions about this form or o<strong>the</strong>r pesticidematters, contact <strong>the</strong> <strong>Montana</strong> Department <strong>of</strong> Agriculture, Agricultural Sciences Division, Helena, MT (406)444-5400.This form is available on our web site at: http://agr.mt.gov/pestfert/miscpdf/RUPsalesForm.pdfRestricted <strong>Use</strong> Pest Sales Rec 06.doc Revised 11/200622
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