Provisional Landscape Pesticide Approval Application

Provisional Landscape Pesticide Approval Application
$50.00

The Provisional Pesticide Approval is issued by the Department of Environment and Local Government as an amendment to the Landscape Pesticide Permit authorizing the application of pesticides above the 50% total lawn/turf area per property per season authorized in the Landscape Pesticide Permit.

* Required fields

* Property owner(s) name:

* Property Street Address:

* Property Municipality:

* Pesticide Operator’s Legal/Operating Name:

* Pesticide Applicator’s name:

* Pesticide Applicator's Certification Number:

* Approximate Date of Pesticide Treatment:

monthly calendar showing the dates from [Month] [Year]

(yyyy-mm-dd)

* Identified Problem Pest:

* Pest Control Product Name and/or Registration Number:

* Total Property Lawn/Turf Area (m2):

* Area (m2) of Property Previously Treated:

* Area (m2) of Property to be treated:

Attach documents here.

* Uploaded files are to be recent photo(s) clearly showing turf damage to the property intended for treatment. For preventative treatments, photo(s) must be of damaged turf within a 250m radius of the property intended for treatment.