Pesticide Application Record For

Pesticide Application Record For

Pesticide Record Keeping Requirements

For New Hampshire

Pesticide applicators are required to maintain records on pesticide applications according to state and national regulations. Pesticide application records can provide valuable production information that can be used to make management decisions or solve production problems.This fact sheet will help you comply with federal and state pesticide record keeping requirements. These requirements are based on thesethree statutes:

  1. The first statute comes from the 2015 New Hampshire Code of Administrative Rules (Division of Pesticide Control, New Hampshire Department of Agriculture, Markets, and Food):

Chapter Pes 900 Record Keeping and Reporting (Statutory Authority: RSA 430:31)

Part Pes 901 Reporting and Report Keeping of Pesticide Use

Pes 901.02 Daily Record Keeping by Registrants or Permittees

(c)The following facts regarding each pesticide application shall be included in records maintained by both commercial and private applicators:

(1)Crop treated, site of treatment, address, and town;

(2)Pesticide and formulation employed;

(3)Dosage applied;

(4)Method of application;

(5)Date or dates of application;

(6)Target organisms; and

(7)The registrants or permittees of the division who participated.

  1. The second statute comes from the Yearly Use Pesticide Reporting Form (Division of Pesticide Control, New Hampshire Department of Agriculture, Markets, and Food) and dictates that the following information must be submitted to the Division:

(1)Name of applicator and firm;

(2)Year covered in the report;

(3)Location/ town (s) of site application;

(4)List of licensees or permittees whose use is included in the report;

(5)Trade name of pesticide;

(6)Amount AI in product (% or # gal);

(7)EPA registration number of product used;

(8)Major crop or site treated;

(9)Number of acres treated; and

(10)Total amount of product used (#, gal, or oz).

  1. The third statute comes from Worker Protection Standard, How to Comply With the 2015 Revised Worker Protection Standard For Agricultural Pesticides – What Owners and Employers Need To Know, EPA 735-B-16-001, Sept. 2016 (United States Protection Agency).:

Chapter 2:Requirements for Agricultural Employers

Page 21:Information Displayed at a Central Location

What Information Must Be Displayed?

  1. Pesticide-specific application information, which must include:

-The location and description of the area to be treated;

-Crop or site treated;

-Product name, EPA registration number, and active ingredient(s) of the pesticide;

-Time and date application started and ended; and

-Restricted-entry interval for the pesticide.

Using this fact sheet every time pesticides are applied will keep you in compliance with these statutes and will help you quickly fill out your annual pesticide use report required by the Division of Pesticide Control.

If you have questions, contact your local UNH Cooperative Extension Agricultural Specialist (listed by county):

BELKNAP
(603) 527-5475 / CARROLL
(603)539-3331 / CHESHIRE
(603) 352-4550 / COOS
(603) 788-4961 / GRAFTON
(603)787-6944
HILLSBOROUGH
(603)641-6060 / MERRIMACK
(603) 225-5505 / ROCKINGHAM
(603) 679-5616 / STRAFFORD
(603) 749-4445 / SULLIVAN
(603) 863-9200

Stop!Read the label on every pesticide container each time before using the material. Pesticides must be applied only as directed on the label to be in compliance with the law. Contact the Division of Pesticide Control at (603)271-3550 to check pesticide registration status. Dispose of empty containers safely, according to New Hampshire regulations.

Note:Additional copies may be obtained from your County Extension office.

Reminder:Do not send this form to the Division of Pesticide Control in Concord. It is not a pesticide use report.

Author:Rachel Maccini,Pesticide Education Coordinator

Education Center, University of New Hampshire Cooperative Extension

329 Mast Road, Suite 115

603-351-3831

The University of New Hampshire Cooperative Extension is an equal opportunity educator and employer.University of New Hampshire, U.S. Department of Agriculture and N.H. counties cooperating.

Revised 05/2017

Pesticide Application Record for:______ / Year:______
Date
(M-D-Y;
Time) / Physical Address / Crop or
Commodity / Applicator / Method of
Application / Target Organism
(Pest) / Trade or
Product Name / Pesticide
Formulation / EPA
Reg. # / Active
Ingredient
Common Name / % Active
Ingredient or Lbs per gallon / Number of Acres or Units / Dosage / Total Amount of Product / Reentry
Interval
Mix / Rate per acre or unit
May 15, 2016
6:30 a.m. / 29 West St. Nashua NH
Block 8 / Apple / Joe Smith / Air-Blast
Orchard
Sprayer / Plum Curculio / Imidan 70-W / Wettable Powder / 10163-169 / Phosmet / 70% / 5 Acres / N/A / 3lbs/acre / 15 lbs / 24 hours
Apple Scab / Captec 4L / Flowable / 51036-181 / Captan / 37.4% or 4lbs/gal / 5 Acres / 1qt/100 gal / 2 quarts/acre / 2.5 gal / 24 hours
Leafminer/Leafhopper / Provado 1.6F / Flowable / 3125-457 / Imidacloprid / 17.4% or 1.6 lbs/gal / 5 Acres / 2 oz/100 gal / 4 fl oz/acre / 20 fl oz / 12 hours

Revised 05/2017