Popular Links
County Agricultural Commissioner forms used for inspections, violation notices and other county enforcement activities
Back to County Agricultural Commissioners Resources
Back to County Implementation and Oversight
Back to Forms Available on DPR’s Website
California Fumigant Management Plan (FMP) templates
Always comply with requirements specified on soil fumigant labeling. These templates are designed to help users meet the requirements that appear on Phase 2 labels of soil fumigants, which began to be distributed in December 2012. In contrast, labels on older fumigant products may require less information, or different information, on either the Fumigant Management Plan or Post-Application Summary.
| Form Number | Form Description |
|---|---|
| DPR-ENF-222, PDF (341 kb) (New 12/10) | Air Monitoring (Field Fumigation) |
| DPR-ENF-223, PDF (387 kb) (New 12/10) | Monitoring During Application (Field Fumigation) |
| DPR-ENF-224, PDF (401 kb) (New 12/10) | Monitoring Post-Application (Field Fumigation) |
| DPR-ENF-225, PDF (309 kb) (New 12/10) | Post-Application Water Treatments (Field Fumigation) |
| DPR-ENF-227, PDF (419 kb) (New 12/12) | Fumigant Management Plan (Field Fumigation) |
| DPR-ENF-228, PDF (400 kb) (New 12/12) | Post-Application Summary (Field Fumigation) |
Inspection forms used by County Agricultural Commissioners
| Form Number | Form Description |
|---|---|
|
PR-ENF-101, PDF (389 kb) (Rev. 01/10) |
Violation Notice |
| PR-ENF-102, PDF (240 kb) (Rev. 01/10) |
Pesticide Pre-Application Site Evaluation |
|
PR-ENF-103, PDF (332 kb) (Rev. 01/10) |
Field Worker Safety Inspection Report |
| PR-ENF-104, PDF (514 kb)
(Rev. 01/10) |
Pesticide Use Monitoring Inspection Report |
| PR-ENF-105, PDF (366 kb)
(Rev. 01/10) |
Commodity Fumigation Use Monitoring Inspection Report |
| PR-ENF-106, PDF (416 kb)
(Rev. 01/10) |
Field Fumigation Use Monitoring Inspection Report |
| PR-ENF-107, PDF (424 kb)
(Rev. 01/10) |
Structural Fumigation Use Monitoring Inspection Report |
| PR-ENF-108, PDF (432 kb)
(Rev. 01/10) |
Structural Use Monitoring Inspection Report |
|
PR-ENF-109, PDF (558 kb) (Rev. 01/10) |
Pest Control Headquarters Inspection Report |
| PR-ENF-110, PDF (483 kb)
(Rev. 01/10) |
Pest Control Business Headquarters Inspection Report |
| PR-ENF-111, PDF (121 kb)
(Rev. 01/10) |
Inspection Report / Violation Notice Supplement |
For content questions contact:
Michael Zeiss
1001 I Street, P.O. Box 4015
Sacramento, CA 95812-4015
Telephone: (916) 324-6680
E-mail: mzeiss@cdpr.ca.gov
Additional forms used by County Agricultural Commissioners
| Form Number | Form Description |
|---|---|
| DPR-071, PDF (78 kb) (Est. 07/05) | Clothing Release Form/Formulario para Entregar la Ropa |
| DPR-161, PDF (449 kb) (Rev. 08/07) | Decision Report |
| DPR-161A, PDF (531 kb) (Est. 08/07) | Decision Report Supplement |
| DPR-197, PDF (116 kb) (Rev. 02/13) | Forms Requisition |
| DPR-ENF-002 TEMP, PDF (363 kb) (Rev. 08/12) | Produce Sample Analysis Report (TEMP) |
| PR-ENF-002, PDF (472 kb) (Rev. 09/10) | Produce Sample Analysis Report |
| PR-ENF-008, PDF (415 kb) (Est. 09/94) | Report of Loss, Nonperformance or Damage |
| DPR-ENF-013A, PDF (25 kb) (Rev. 01/11) | California Restricted Materials Requirements |
| DPR-ENF-013B, PDF (31 kb) (Rev. 03/06) | Ground Water Protection Materials |
| DPR-ENF-013C, PDF (36 kb) (Rev. 11/02) | Minimal Exposure Pesticides |
| PR-ENF-016, PDF (433 kb) (Est. 09/09) | Operator Identification Number Application |
| PR-ENF-017A, PDF (189 kb) (Rev. 08/08) | Production Agriculture Monthly Pesticide Use Report |
| PR-ENF-017B, PDF (168 kb) (Rev. 08/08) | Production Agriculture Monthly Pesticide Use Report Supplement
|
| DPR-ENF-030, PDF (857 kb) (Rev. 11/12) | Investigative Sample Analysis Report |
| DPR-ENF-046, PDF (1.2 mb) (Rev. 02/13) | Enforcement/Compliance Action Summary
(Instructions and Procedures)
|
| DPR-ENF-072, PDF (37 kb) (Rev. 02/11) | Enforcement and Compliance Options Chart |
| PR-ENF-074, PDF (120 kb) (Est. 09/94) | Complaint of Human Exposure or Unsafe Condition |
| DPR-ENF-086, PDF (38 kb)(Rev. 05/12) | Preparing for Your Administrative Pesticide Penalty
Hearing |
| PR-ENF-097, PDF (307 kb) (Rev. 06/07) | Pesticide Illness Investigation Request for Time Extension
|
| PR-ENF-099, PDF (204 kb) (Rev. 03/03) | Pesticide Regulatory Activities Monthly Report |
| PR-ENF-100A, PDF (21 kb) (Est. 03/94) | Statement |
| PR-ENF-100B, PDF (19 kb) (Est. 03/94) | Statement Continuation |
| PR-ENF-125, PDF (116 kb) (Rev. 11/07) | Application - Restricted Materials Permit |
| PR-ENF-125A, PDF (578 kb) (Rev. 10/07) | Application - Restricted Materials Permit - Supplemental |
| PR-ENF-126, PDF (442 kb) (Rev. 11/07) | Notice of Intent to Apply Restricted Materials |
| PR-ENF-127, PDF (552 kb) (Rev. 08/07) | Pesticide Episode Investigation Report |
| PR-ENF-127A, PDF (430 kb) (Rev. 08/07) | Pesticide Episode Investigation Supplemental Report |
| PR-ENF-127B, PDF (504 kb) (Rev. 08/07) | Episode Witness/Injured/Complainant Report |
| PR-ENF-127C, PDF (602 kb) (Rev. 08/07) | Episode Site Diagram |
| PR-ENF-127D, PDF (694 kb) (Rev. 08/07) | Field Worker Dermatitis Supplemental Report |
| PR-ENF-128, PDF (572 kb) (Est. 12/03) | Pesticide Episode Investigation Non-Occupational Exposure Supplement |
| PR-ENF-133, PDF (20 kb) (Rev. 02/04) | Medical Information Authorization |
| PR-ENF-133X, PDF (22 kb) (Rev. 02/04) | Autorización de Información Médica |
| PR-ENF-149, PDF (115 kb (Rev. 05/04) | Pesticide Statutes Violation Notice |
|
DPR-ENF-162, PDF (31 kb)
(Rev. 02/11) |
Summary of Pesticide Use Regulatory Authorities |
| PR-ENF-182, PDF (162 kb) (Est. 10/91) | Antimicrobial Exposure Episode Report |
| PR-ENF-199, PDF (671 kb) (Rev. 05/04) | Pesticide Analysis Report |
| PR-ENF-211, PDF (158 kb) (Rev. 04/03) | Complaint Referral |
| PR-ENF-212, PDF (94 kb) (Rev. 04/03) | Complaint Referral - Supplemental |
| PR-PML-045, PDF (20 kb) (Rev. 12/06) | Private Applicator Certificate Application |
| Pesticide use reporting forms |