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Address

Report the street address including the building or lot number where the pesticide was applied or the purchaser intended to apply.  We cannot accept P.O. Boxes in this column

EPA Registration Number and Product Name

These columns can be filled in by selecting a product in the EPA Reg Number List or by typing in the cells. 

Forms: 25, 26, 27

Units or Container Units

Reporting Column - required

County Code

The Units column on Forms 26 and 27 and the Container Units column on Form 25 have a drop-down list for easy entry of units. To use the list, click or tab into the cell, then click the  downward-pointing arrowhead.column for County Code.  A list of accepted Units is displayed; click on one to populate it to the cell.

Forms: 25,26, 27

Quantity

The undiluted amount of pesticide applied or soldcounty codes is included in the appendix. As an added convenience, a county codepopup dialog is available to help you select the correct county code. 

Forms: 25, 26, 27

Reporting Column - required

Date(s)

The date of application (Form 26) or the date the product was sold (Form 27). Date values must be entered in one of these formats (where mm=month, dd=day, yyyy=year):

• mm/dd/yyyy

...

• mm-dd-yyyy

...

• mm-dd

...

• mm/dd

...

...

...

Form 26 includes an End Date column that is used to specify the end of a date range where the Apply Date is the beginning of the range.  This column is for automated applications (e.g. cooling towers, water treatment facilities). Leave this column blank if it does not apply to you.

Forms: 26, 27

County Code

...

Reporting Column - required

Dosage Rate

Enter the amount of pesticide used for a given application; e.g., 1 fluid ounce/gallon (FL/GL); 1 gram/12 inches (GM/IN), etc. (This is the premix or final mix dosage rate listed on the pesticide label.)

Forms: 26

Record Keeping Column - optional

EPA Registration Number and Product Name

These columns can be filled in by selecting a product in the EPA Reg Number List or by typing in the cells. 

Forms: 25,26, 27

Reporting Column - required

Method of Application

Method used to apply the pesticide (broadcast, hand placement, aerial, etc.)

Forms: 26

Record Keeping Column - optional

Municipality

Report the village, town or city

Forms: 26, 27

Address and  Municipality

Report the street address and city or town where the pesticide was applied or the purchaser intended to apply the pesticide.  The municipality name should match the zip code (e.g., 11375 should be Forest Hills and not Queens).

Forms: 26, 27

Reporting Column - required

Place of Application

Enter location where the pesticide was applied (greens 3 & 7 of golf course; front lawn area, restaurant kitchen, etc.)

Forms: 26

Record Keeping Column - optional

Quantity

The undiluted amount of pesticide applied or sold. 

Forms: 25,26, 27

Reporting Column - required

Target Organism(s)

Enter the name of the targeted pest(s). The targeted pest or organism must be listed on the pesticide label.

Forms: 26

Record Keeping Column - optional

Units or Container Units

The Units column on Forms 26 and 27 and the Container Units column on Form 25have a drop-down list for easy entry of units. To use the list, click or tab into the cell, then click the  downward-pointing arrowhead.  A list of accepted Units is displayed; click on one to populate it to the cell.

Forms: 25,26, 27

Reporting Column - required

Zip Code

The undiluted amount of pesticide applied or sold. 

Forms: 25,26, 2727

Reporting Column - required