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  (530 kb) (New 12/10) Air Monitoring (Field Fumigation)

DPR-ENF-223, PDF  (367 kb) (New 12/10) Monitoring During Application (Field Fumigation)

DPR-ENF-224, PDF  (588 kb) (New 12/10) Monitoring Post-Application (Field Fumigation)

DPR-ENF-225, PDF  (299 kb) (New 12/10) Post-Application Water Treatments (Field Fumigation)

DPR-ENF-227, PDF  (423 kb) (New 12/12) Fumigant Management Plan (Field Fumigation)

DPR-ENF-228, PDF  (331 kb) (New 12/12) Post-Application Summary (Field Fumigation)

Inspection forms used by County Agricultural Commissioners

Form Number Form Description
PR-ENF-101, PDF (54 kb) (Rev. 01/10)
Violation Notice

PR-ENF-102, PDF (95 kb) (Rev. 01/10)
Pesticide Pre-Application Site Evaluation

PR-ENF-103, PDF (207 kb) (Rev. 01/10)
Field Worker Safety Inspection Report

PR-ENF-104, PDF (297 kb) (Rev. 01/10)
Pesticide Use Monitoring Inspection Report

PR-ENF-105, PDF (296 kb) (Rev. 01/10)
Commodity Fumigation Use Monitoring Inspection Report

PR-ENF-106, PDF (204 kb) (Rev. 01/10)
Field Fumigation Use Monitoring Inspection Report

PR-ENF-107, PDF (302 kb) (Rev. 01/10)
Structural Fumigation Use Monitoring Inspection Report

PR-ENF-108, PDF (339 kb) (Rev. 01/10)
Structural Use Monitoring Inspection Report

PR-ENF-109, PDF (433 kb) (Rev. 01/10)
Pest Control Headquarters Inspection Report

PR-ENF-110, PDF (370 kb) (Rev. 01/10)
Pest Control Business Headquarters Inspection Report

PR-ENF-111, PDF (96 kb) (Rev. 01/10)
Inspection Report / Violation Notice Supplement

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  (100 kb) (Rev. 08/07) Decision Report

DPR-161A, PDF  (83 kb) (Est. 08/07) Decision Report Supplement

DPR-197, PDF (116 kb) (Rev. 03/14) Forms Requisition

DPR-ENF-002, PDF (335 kb) (Rev. 07/13) Produce Sample Analysis Report

PR-ENF-008, PDF (27 kb) (Est. 09/94) Report of Loss, Nonperformance or Damage

DPR-ENF-013A, PDF (34 kb) (Rev. 07/15) California Restricted Materials Requirements

DPR-ENF-013A-SP, PDF (39 kb) (Rev. 07/15) Requisitos Para Materiales Restringidos en California

DPR-ENF-013B, PDF (33 kb) (Rev. 10/13) Ground Water Protection Materials

DPR-ENF-013C, PDF (30 kb) (Rev. 03/17) Minimal Exposure Pesticides

PR-ENF-016, PDF (348 kb) (Est. 09/09) Operator Identification Number Application

DPR-ENF-030, PDF (457 kb) (Rev. 03/16) Investigative Sample Analysis Report

DPR-ENF-046, PDF (764 kb) (Rev. 01/15) Enforcement/Compliance Action Summary (Instructions and Procedures)

DPR-ENF-047, PDF (542 kb)
(NEW 01/15)
Enforcement/Compliance Action Summary Supplemental (Instructions and Procedures)

DPR-ENF-072, PDF (32 kb) (Rev. 10/16) Enforcement and Compliance Options Chart

PR-ENF-074, PDF (55 kb) (Rev. 09/94) Complaint of Human Exposure or Unsafe Condition

DPR-ENF-086, PDF (154 kb)(Rev. 09/15) Preparing for Your Administrative Pesticide Penalty Hearing

PR-ENF-097, PDF (589 kb) (Rev. 06/07) Pesticide Illness Investigation Request for Time Extension

PR-ENF-099, PDF  (1.4 mb) (Rev. 03/03) Pesticide Regulatory Activities Monthly Report

PR-ENF-100A, PDF (16 kb) (Est. 03/94) Statement

PR-ENF-100B, PDF (15 kb) (Est. 03/94) Statement Continuation

PR-ENF-125, PDF (94 kb) (Rev. 11/07) Application - Restricted Materials Permit

PR-ENF-125A, PDF (445  kb) (Rev. 10/07) Application - Restricted Materials Permit - Supplemental

PR-ENF-126, PDF (93 kb) (Rev. 11/07) Notice of Intent to Apply Restricted Materials

PR-ENF-127, PDF (337 kb) (Rev. 08/07) Pesticide Episode Investigation Report

PR-ENF-127A, PDF (124 kb) (Rev. 08/07) Pesticide Episode Investigation Supplemental Report

PR-ENF-127B, PDF (374 kb) (Rev. 08/07) Episode Witness/Injured/Complainant Report

PR-ENF-127C, PDF (540 kb) (Rev. 08/07) Episode Site Diagram

PR-ENF-127D, PDF (271 kb) (Rev. 08/07) Field Worker Dermatitis Supplemental Report

PR-ENF-128, PDF (102 mb) (Est. 12/03) Pesticide Episode Investigation Non-Occupational Exposure Supplement

DPR-ENF-130, Word (84 kb)  (Est. 06/15) Photo Mount

DPR-ENF-133, PDF (23 kb) (Rev. 07/13) Medical Information Authorization

DPR-ENF-133X, PDF (20 kb) (Rev. 07/13) Autorización de Información Médica

DPR-ENF-162, PDF (52 kb) (Rev. 02/11)
Summary of Pesticide Use Regulatory Authorities

PR-ENF-182, PDF (49 kb) (Est. 10/91) Antimicrobial Exposure Episode Report

PR-ENF-199, PDF (338 kb) (Rev. 05/04) Pesticide Analysis Report

PR-ENF-211, PDF (45 kb) (Rev. 04/03) Complaint Referral

PR-ENF-212, PDF (23 kb) (Rev. 04/03) Complaint Referral - Supplemental

PR-PML-045, PDF (36 kb) (Rev. 12/06) Private Applicator Certificate Application

Pesticide use reporting forms  

For content questions, contact:
Roy Hirose
1001 I Street, P.O. Box 4015
Sacramento, CA 95812-4015