Application of the Herbicide Is the Responsibility of the Landowner Or Operator

The applications for this spray season have been consolidated on one page. We will again distribute on select dates throughout the summer. You will not receive a letter telling you when to pick up your herbicide. Select the date that works for you.

 Check the herbicides you have on hand and request only what you think you’ll need for the current season.

 Application of the herbicide is the responsibility of the landowner or operator.

 Do not send payment with this request. Payment is due when you pick up your herbicide.

 Cost-share percentages are: 40% landowner; 60% county.

 Please fill out this form completely and accurately.

 If you require more space for land description, use the back side of the application or another sheet of paper. Be sure to indicate which herbicide the land description is for.

 Distribution will be at the shop: 52-1/2 30th Ave. W. behind the Stark Co. Road shop. Please do not go to the Extension Office.

 Applications should be received at the office before distribution.

 Please call the office if you need more information before making your herbicide selection. Stark County Weed Control Board

Milestone/Liberate (NIS) – (Canada thistle, absinth wormwood) Coverage: 1 qt. covers approx. 5 acres (4.5-6 acres) Milestone is not labeled for cropland. No maximum Price: _____$93.00_____ per quart + NIS LAP Cost: _____$37.20_____

Legal description of the land where the herbicide will be applied: 1/4 ______Sec. ______TWP ______Range ______1/4 ______Sec. ______TWP ______Range ______1/4 ______Sec. ______TWP ______Range ______1/4 ______Sec. ______TWP ______Range ______

Total Acres to be Treated ______Total Qts./Gals. Milestone Requested ______

Plateau/MSO – (leafy spurge) Coverage: approx. 16 acres Price: _____$156.00_____ per gal. + 5 gals. MSO LAP Cost: _____$62.40_____

Total Acres to be Treated ______Total Gals. Plateau Requested ______

Tordon/2,4-D – (leafy spurge) Coverage: approx. 8 acres Price: _____$70.00_____ per gal. + 2.5 gals. of 2,4-D LAP Cost: _____$28.00_____

Legal description of the land where the herbicide will be applied: 1/4 ______Sec. ______TWP ______Range ______1/4 ______Sec. ______TWP ______Range ______1/4 ______Sec. ______TWP ______Range ______

Total Acres to be Treated ______Total Gals. Tordon Requested ______

Name on Private Applicator’s Certificate ______Number ______

3-way mix – (leafy spurge) (Tordon, Plateau, MSO) Coverage: approx. 16 acres Price: _____$201.00_____ per unit of 3 LAP Cost: _____$80.40_____

Total Acres to be Treated ______Total Gals. 3-way mix Requested ______

Name on Private Applicator’s Certificate ______Number ______

Printed Name: ______Signature: ______Address: ______City, State, Zip: ______Phone #: ______Cell #: ______E-mail: ______