Pesticide application checklist - duplicate

• Site name

• Conducted on

  Date

• Prepared by

• Location
  Address

• Pesticide being used

  Select

• Has the application rate been agreed and contractor issued with Gazelle SG mixing and calibration document?

  Yes

  No

  N/A

People

• Are all operators qualified?

  Yes

  No

  Don't know

• Are copies of certificates on file?

  Yes

  No

  N/A

CoSHH & PPE

• Does the CoSHH assessment identify appropriate PPE?

  Yes

  No

  N/A

• Eye/face protection (EN 166)

• Protective gloves (EN 374)

• Protective coveralls

• Water-repellent boots

• Has the contractor been issued with the CoSHH assessment and the PPE agreed?

  Yes

  No

  N/A

Pesticide approvals

• Has the "off-label" approval been checked and provided to the contractor?

  Yes

  No

  N/A

Buffer zones

• Has the site been walked and watercourses marked on map?

  Yes

  No

  N/A

• Have drains been checked to ensure they are not connected to watercourses?

  Yes

  No

  N/A

• Are more sensitive areas, such as water sources or designated sites, marked on ground with canes and tape?

  Yes

  No

  N/A

Equipment

• Does the contractor have appropriate site and vehicle pesticide storage container?

  Yes

  No

  N/A

• Do operators have appropriate nozzles for the task?

  Yes

  No

  N/A

Records

• Does the contractor understand the reporting requirements and have the appropriate form?

  Yes

  No

  N/A

Public access

• Are access routes identified on the map?

  Yes

  N/A

• Are temporary diversions necessary?

  Yes

  No

  N/A

• Does the access need buffer areas left untreated?

  Yes

  No

  N/A

• Have path buffers been marked with canes and tape?

  Yes

  No

  N/A

• Has sign placement been planned to cover likely points of access?

  Yes

  No

  N/A

Designated sites

• Does the site cover any areas of high conservation value? E.g SSSI, SAC, SPA

  Yes

  No

  N/A

• Has the appropriate agency been consulted?

  Yes

  No

  N/A

• Has approval been obtained?

  Yes

  No

  N/A

Site map

• Has the site map been checked and given to contractor?

  Yes

  No

  N/A

Records

• Has the pesticide application record been returned by contractor?

  Yes

  No

  N/A

• Has the pesticide application record been checked and filed?

  Yes

  No

  N/A

• Have ill-effects (if any reported) been recorded and followed up?

  Yes

  No

  N/A

Public access

• Have signs been removed from site the following day?

  Yes

  No

  N/A

Waste management

• Has all waste been removed from site and disposed of correctly?

  Yes

  No

  N/A

Observations

• Date

  Date

• Comments

• Follow-up visits

  Yes

• Date

  Date

• Comments

• Date

  Date

• Comments

• Date

  Date

• Comments

• Date

  Date

• Comments