County Agricultural Commissioner forms used for inspections, violation notices and other county enforcement activities

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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.

California Fumigant Management Plan (FMP) templates
Form Number Form Description
DPR-ENF-222, PDF (New 12/10) Air Monitoring (Field Fumigation)

DPR-ENF-223, PDF (New 12/10) Monitoring During Application (Field Fumigation)

DPR-ENF-224, PDF (New 12/10) Monitoring Post-Application (Field Fumigation)

DPR-ENF-225, PDF (New 12/10) Post-Application Water Treatments (Field Fumigation)

DPR-ENF-227, PDF  (New 12/12) Fumigant Management Plan (Field Fumigation)

DPR-ENF-228, PDF  (New 12/12) Post-Application Summary (Field Fumigation)

Inspection forms used by County Agricultural Commissioners

Inspection forms used by County Agricultural Commissioners
Form Number Form Description
PR-ENF-101, PDF (Rev. 01/10)
Violation Notice

PR-ENF-111, PDF (Rev. 01/10)
Inspection Report / Violation Notice Supplement

Additional forms used by County Agricultural Commissioners

Additional forms used by County Agricultural Commissioners
Form Number Form Description
DPR-071, PDF (Est. 07/05) Clothing Release Form/Formulario para Entregar la Ropa

DPR-161, PDF (Rev. 08/07) Decision Report

DPR-161A, PDF (Est. 08/07) Decision Report Supplement

DPR-197, PDF (Rev. 02/18) Forms Requisition

DPR-ENF-002, PDF (Rev. 07/13) Produce Sample Analysis Report

PR-ENF-008, PDF (Est. 09/94) Report of Loss, Nonperformance or Damage

DPR-ENF-013A, PDF (Rev. 11/21) California Restricted Materials Requirements

DPR-ENF-013A-SP, PDF (Rev. 11/21) Requisitos Para Materiales Restringidos en California

DPR-ENF-013B, PDF (Rev. 10/13) Ground Water Protection Materials

DPR-ENF-013C, PDF (Rev. 03/17) Minimal Exposure Pesticides

PR-ENF-016, PDF (Est. 09/09) Operator Identification Number Application

DPR-ENF-030, PDF (Rev. 03/21) Investigative Sample Analysis Report

LIC-045, PDF (Rev. 07/23) Private Applicator Certificate Application

DPR-ENF-046, PDF (Rev. 01/15) Enforcement/Compliance Action Summary (Instructions and Procedures)

DPR-ENF-055, PDF (Est. 03/14) Pesticide Episode Closing Report

DPR-ENF-047, PDF (NEW 01/15) Enforcement/Compliance Action Summary Supplemental (Instructions and Procedures)

DPR-ENF-072, PDF (Rev. 01/23) Enforcement and Compliance Options Chart

PR-ENF-074, PDF (Rev. 09/94) Complaint of Human Exposure or Unsafe Condition

DPR-ENF-086, PDF (Rev. 04/23) Preparing for Your Pesticide Administrative Civil Penalty Hearing

PR-ENF-097, PDF (Rev. 06/07) Pesticide Illness Investigation Request for Time Extension

PR-ENF-100A, PDF (Est. 03/94) Statement

PR-ENF-100B, PDF (Est. 03/94) Statement Continuation

DPR-ENF-114, PDF (Est. 03/14) Pesticide Episode Notification Record

DPR-ENF-115, PDF (Est. 03/14) Pesticide Episode 15-Day Report

PR-ENF-125, PDF (Rev. 11/07) Application - Restricted Materials Permit

PR-ENF-125A, PDF (Rev. 10/07) Application - Restricted Materials Permit - Supplemental

PR-ENF-126, PDF (Rev. 11/07) Notice of Intent to Apply Restricted Materials

PR-ENF-127, PDF (Rev. 08/07) Pesticide Episode Investigation Report

PR-ENF-127A, PDF  (Rev. 08/07) Pesticide Episode Investigation Supplemental Report

PR-ENF-127B, PDF (Rev. 08/07) Episode Witness/Injured/Complainant Report

PR-ENF-127C, PDF (Rev. 08/07) Episode Site Diagram

PR-ENF-127D, PDF (Rev. 08/07) Field Worker Dermatitis Supplemental Report

PR-ENF-128, PDF (Est. 12/03) Pesticide Episode Investigation Non-Occupational Exposure Supplement

DPR-ENF-130, PDF (Est. 06/15) Photo Mount

DPR-ENF-133, PDF (Rev. 07/13) Medical Information Authorization

DPR-ENF-133X, PDF (Rev. 07/13) Autorización de Información Médica

DPR-ENF-162, PDF (Rev. 02/11)
Summary of Pesticide Use Regulatory Authorities

PR-ENF-199, PDF (Rev. 05/04) Pesticide Analysis Report

PR-ENF-211, PDF (Rev. 04/03) Complaint Referral

PR-ENF-212, PDF (Rev. 04/03) Complaint Referral - Supplemental

Pesticide use reporting forms  

For content questions, contact:
Erin Shibata
3077 Fite Circle, Suite 100
Sacramento, CA 95827