Form Agr 630-4129 - Aquatic Risk Assessment - Washingtonstate Department Of Agriculture

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Washington State Department of Agriculture
Pesticide Management Division
1111 Washington Street SE, 2nd Floor
•
P.O. Box 42589
Olympia, WA 98504-2589
•
Telephone: (360) 902-2025
FAX: (360) 902-2093
•
E-mail
pestreg@agr.wa.gov
Web site
AQUATIC RISK ASSESSMENT
Pesticide Trade Name:
Chemical Name of Active Ingredient(s):
EPA Reg. No.:
Tech. grade
Test Result:
Period of
1
Test Organism
Most Sensitive Species
a.i.
LC or EC
Exposure
MRID
50
50
( % purity)
Value (ppm)
(hours)
Freshwater Fish
Freshwater Invertebrates
1
Master Record Identification Number: EPA system of recording and tracking studies submitted.
Crop/Site Name:
GENEEC 2 Model Input Parameters
Value (Data)
Reference Source (i.e. MRID)
Maximum Application Rate
(Maximum Requested Rate)
(lbs. ai /acre)
Maximum No. of Applications Per Year
(Maximum Requested Number)
Minimum Interval Between Treatments
(Requested Minimum)
Days
1
Kd
Koc (Organic Carbon Fraction)
Maximum Aerobic Soil Metabolic Half- life
Days
Is the pesticide incorporated
Yes 
No 
with water?
Depth of Incorporation
(Current label minimum)
Inches
Method of Application
A. Aerial Spray 
B. Ground Spray 
C. Airblast Spray 
D. Granular (Non-spray) 
Aerial Spray
Ground Spray – Nozzle Height
Airblast Spray
A. Orchards/Dormant Vineyards 
A. Very Fine to Fine
A. Low Boom (< 20 inches or less)
B. Fine to Medium (EFED default)
B. Foliated Vineyards
B. High Boom Ground Sprayer
C. Medium to Coarse
(< 20 to 50 inches: EFED default)
D. Coarse to Very Coarse
Ground Spray –Droplet Size
A. Fine (EFED default)
B. Medium-Coarse
Buffer Width (No-Spray Zone)
Ft.
Water Solubility
mg/l
2
Aerobic Aquatic Metabolic Half- life
Days
2
pH 7 Hydrolysis Half- life
Days
2
Photolysis Half- life
Days
Signature:
Date:
(Official Use Only)
1
2
Lowest “non- sand” value;
Maximum value (If stable, use 0).
AGR 630-4129 (R/10/16)

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