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Aerial Application Job Order
Client
Property
Date
Date Required
Priority
Low
Medium
High
Field & Chemical
Field Name/No
Ha
Product 1
Rate
Product 2
Rate
Product 3
Rate
Wetter
Rate
Water Rate
×
Add Field
Have you notified your neighbours?
-
Yes
No
Are there any occupied dwellings within 150m of the treatment area? If yes we require written permission
-
Yes
No
Are there any special considerations for any of the following:
Susceptible Crops
(including neighbours crops)
-
Yes
No
Please Provide Details
Grazing Land/Grazing Stock
-
Yes
No
Please Provide Details
Pastures
-
Yes
No
Please Provide Details
Rivers and Channels
(especially drainage)
-
Yes
No
Please Provide Details
Houses/Gardens
-
Yes
No
Please Provide Details
Aquatic Farms/Dams/Waterways
-
Yes
No
Please Provide Details
Roads/Stock Routes
-
Yes
No
Please Provide Details
Fences
-
Yes
No
Please Provide Details
Trees, in particular dead limbs
-
Yes
No
Please Provide Details
Power Lines
-
Yes
No
Please Provide Details
Bee Sites
-
Yes
No
Please Provide Details
Flora/Fauna
-
Yes
No
Please Provide Details
Organic Farms
-
Yes
No
Please Provide Details
Workers/Contractors
-
Yes
No
Please Provide Details
Towns
-
Yes
No
Please Provide Details
Are there any other environmental considerations or special instructions?
-
Yes
No
Please Provide Details
I hereby declare that all the information provided in this spraycheck list is complete, true and correct, and that I have read and understand the
terms and conditions
.
Name
Date Accepted
Email Address
(used to send order confirmation)
Submit Job Order