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PESTICIDE SPRAY DIARYMeets Recording Requirements for Pesticide Applications under the following
- Ag Vet Control of use Regulations NT
Prepared by:Department of Primary Industry and Fisheries
Chemical Services SectionVersion 5
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Agricultural Chemical Spray Record[Suitable for frequent application to the same areas – such as owners and employees of farming
operations]Name & Address of person for whom the spraying was carried out [land owner or lessee: ................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
Operators Details
Operator 1 - Name:..............................................................................................................
Address:..........................................................................................................
Spray Applicator Licence No. (If applicable) :........................................................................
Authorisation for S7 or Restricted Product (if applicable):......................................................
Operator 2 - Name:.............................................................................................................
Address:..........................................................................................................
Spray Applicator Licence No. (If applicable) :........................................................................
Authorisation for S7 or Restricted Product (if applicable) ......................................................
Operator 3 - Name:.............................................................................................................
Address:..........................................................................................................
Spray Applicator Licence No. (If applicable) :........................................................................
Authorisation for S7 or Restricted Product (if applicable) ......................................................
Operator 4 - Name:............................................................................................................
Address:..........................................................................................................
Spray Applicator Licence No. (If applicable) : .......................................................................
Authorisation for S7 or Restricted Product (if applicable) ......................................................
Certification by OperatorI hereby certify that this spray diary contains a true and accurate record of my agricultural spraying activities on the properties described in this diary.Signed : Operator1: ..............................................................Date:............/......../............
Signed : Operator 2: ..............................................................Date:............/......../............
Signed : Operator 3: ..............................................................Date............./......../............
Signed : Operator 4: ..............................................................Date ............/......../............
The information in this diary must be retained for 2 years after the date of spray application as prescribed in the Agricultural and Veterinary Control of Use Regulations, 2004, regulation 9.
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Property Map and Location – Property 1Address of property........................................................................................................................................................................................
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Property Map and Location – Property 2Address of property:.......................................................................................................................................................................................
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RECORDS OF PESTICIDE APPLICATIONS CARRIED OUT
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Grower: ……………………. Farm Location:…………………………………………………
Date Time Time Location Chemical Rate Method Crop Pest & Notes Wind OperatorStart Finish [ref.map] Sign
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Grower: ……………………. Farm Location:…………………………………………………
Date Time Time Location Chemical Rate Method Crop Pest & Notes Wind OperatorStart Finish [ref.map] Sign
EXAMPLES OF HOW TO FILL OUT THIS DIARY
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Extract from Agricultural &Veterinary Chemicals Control of Use Regulations 2004
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