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Application Record Keeping Form - DuPont

Application Record Keeping FormCertified Applicator Name: State Certification # of Applicator: Applicator Name (if different from Certified Applicator): Applicator Name (if different from Certified Applicator): Provider (be sure to retain proof of completion): Date Completed (MM/DD/YY): REQUIRED DICAMBA APPLICATOR TRAININGName and Date of the Sensitive Crop Registry Consulted: AND/ORDate Neighboring Fields Were Surveyed for Susceptible Crops: Retain receipt of each purchase for each Application .

DuPont ™ FeXapan herbicide Plus VaporGrip® Technology is a restricted-use pesticide. DuPont™ FeXapan™ herbicide Plus VaporGrip® Technology is not registered for sale or use in all states. Contact your DuPont retailer or representative for details and availability in your state. IT IS A VIOLATION OF FEDERAL AND STATE LAW TO MAKE AN IN …

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