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Pesticide Application Request Form
Jack Dalrymple Agricultural Research Complex
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Pesticide Application Request Form
Name
Department
Project
Office Phone Number
Cell Number
Email Address
Date of Application
Requests for applications need to be submitted by noon on Mondays and Thursdays. Applications are made between 3:30 pm and 6:00 pm. Please ensure workers have exited the greenhouses by 3:30 pm and remain out of the area until the re-entry interval has expired. If workers are present in your greenhouse, chemical applications will NOT be completed.
Location
USDA NCSL Greenhouses
USDA BRL Greenhouses
USDA SES Greenhouses
Lord and Burnham Greenhouses- Agronomy
Lord and Burnham Greenhouses- Plant Pathology/Horticulture
Waldron Greenhouses
Dalrymple (AES) Greenhouse Complex
Room Number(s)
Crop
Spot Spray Application Request
Please identify the problem below. If you are unsure of the insect or pathogen causing the issue, please contact greenhouse staff and we will help you with identification. If you would like notification of the product we plan to apply, please request notification in the special instructions box.
Aphids
White Flies
Thrips
Spider Mites
Powdery Mildew
Other- Please describe in special instructions
Applications Requiring Prior Approval
Please include the name and certification number of the applicator in the special instructions field. Greenhouse staff will send you an email confirmation with approval/disapproval on the day of the planned application.
Granular Imidacloprid Application
Herbicide Application
Other- Please describe in special instructions
Special Instructions
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