Sportsfields - CHEMICAL SPRAY RECORD

OHS (JSA)

• Pre-operational checks have been completed on all spray equipment and the equipment is working as intended

• I have the correct PPE (Gloves, Goggles, Face Mask, Protective clothing - Including safety boots) and it is in good condition and I have worn the appropriate PPE for the duration of my on-site presence

• I have identified all the risks to the public, waterways, off target areas, neighbouring property and wildlife involved in making this

• As the applicator of the previously mentioned chemicals I hereby certify that I have read the previous information and the chemical

• The product/s being used are registered for the purpose and situation that they are being applied

• The site was safe under the Precision Turf Safe Job Site Policy (if no, comments and photos should support)

• I have set up a 'mobile work site' and used appropriate 'spraying in progress' signage

SPRAY DETAILS

• Operator Name

• Date

  Date

• Spotter required? (is Yes, provide details on spotter name)

  Yes

  No

  N/A

SITE DETAILS

• Site Name
  Address

• Site Location

  Select

• Area size

• Turf Species

  Select

• Irrigation after application require?

  Yes

  No

  N/A

EQUIPMENT DETAILS

• Equipment Name

  Select

• Machine output

  Select

• Nozzle size

  Select

PRODUCT 1

• Product

  Select

• Category

  Select

• Target

  Select

• Rate/Ha

• Total amount of product used

PRODUCT 2

• Product

  Select

• Category

  Select

• Target

  Select

• Rate/Ha

• Total amount of product used

START OF APPLICATION

• Start Time

  Date

• Temperature

• Wind

END OF APPLICATION

• Start Time

  Date

• Temperature

• Wind

DECLARATION AND SIGNATURE

• I declare that the information provided within this form is accurate as at the date of completion

  Yes

  No

  N/A

• Signed by Operator

  Sign