DIRECTIONS:  Fill in each item every time you apply or supervise the application of a restricted use pesticide.  Keep this record for two years after date of application.   You may keep records in any format you like  (this form,computer, notebook, etc.). DATE Name of Location of Brand Name Site or Amount Purpose of Amound of   TEMPERATURE Wind  Velocity RESTRICTED ENTRY    Certified  Application and Item Treated Application Undulated Matl     & Director INTERVAL*   Applicator   EPA REG # Treated     Used Start Finish Start Finish Hours Expiration