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, State, Zip:Address:License Number:Date ofSalePurchaser's NameLicense/Permit No.Purchaser'sAddressPesticidePesticide Trade NameCompanyName EPA Reg. # and/or SLN #VolumeSold(lbs or gals)Instructions: This record will satisfy minimum requirements of 4.10.504 Administrative Rules of Montana and Title 40 Code of Federal Regulations 171.12for sales of restricted use pesticides. The record must be filled out for each sale of a restricted use pesticide. Sales of restricted use pesticides shall bemade only to certified applicators in possession of valid licenses or permits issued by the Montana Department of Agriculture. Prior to making a sale of arestricted use pesticide, dealers are required to confirm this by viewing the purchaser's license or permit. For questions about this form or other pesticidematters, contact the Montana Department of 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 Use Pest Sales Rec 06.doc Revised 11/200622
FORM 2. DAILY PESTICIDE APPLICATION RECORDSCompliments of theMONTANA DEPARTMENT OF AGRICULTUREAGRICULTURAL SCIENCES DIVISIONPO BOX 200201HELENA, MT 59620-0201Phone: 406-444-5400BUSINESSDAILY PESTICIDE APPLICATION RECORDLICENSE#NAMEADDRESSCITY, STATE, ZIPPHONECUSTOMERPHONEADDRESSAPPLICATION #1 APPLICATION #2Applicator/Operator NameDateCountyTime Start/StopTemperatureWind Speed/Direction (from)Pesticide ManufacturerTrade NameEPA Reg# or FormulationRate: Product/Diluent Per AcreCrop or Site & Crop StagePest(s)Equipment UsedAcres/Area TreatedLocation #1COMMENTS/MAP:Location This #2 form is available on our web site at: http://agr.mt.gov/pestfert/miscpdf/RecordKeepingForm.pdfforms/Daily Pesticide App Rec.doc23
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Montana State Laws and Regulations Pertaining to the Use of ...

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