State of California
Department of Pesticide Regulation
FORMS REQUISITION
DPR-197 (Rev. 1/16)
Page 1 of 5
COUNTY: _________________________________________
PHONE NO.: __________________________________
ORDERED BY: _____________________________________
FAX NO.: _____________________________________
ADDRESS: _________________________________________
NO. OF PAGES: ________________________________
_________________________________________
DATE ORDERED: ______________________________
Please allow two weeks for processing your forms order after receipt. You may fax (916) 445-6845; mail (Department
of Pesticide Regulation, Attn: CAC Forms Coordinator, P.O. Box 4015, Sacramento, CA 95812-4015); or e-mail your
requisition to the CAC Forms Coordinator <formscoordinator@cdpr.ca.gov>. In order to accurately track orders, ALL
FORM ORDERS MUST BE SUBMITTED IN WRITING; NO ORDERS WILL BE TAKEN OVER THE TELEPHONE. If
you have any questions regarding this requisition, please contact the CAC Forms Coordinator at
<formscoordinator@cdpr.ca.gov>.
DEPARTMENT OF PESTICIDE REGULATION (DPR)
FORM NUMBER
FORM NAME
QUANTITY
DPR-071
Clothing Release Form / Formulario para Entregar la Ropa (Est. 07/05)
_________
DPR-161
Decision Report (Rev. 08/07)
_________
DPR-161A
Decision Report Supplemental (Rev. 08/07)
_________
DPR-197
Forms Requisition (Rev. 1/16)
_________
ENFORCEMENT
DPR-ENF-002
Produce Sample Analysis Report (Rev. 7/13)
_________
PR-ENF-008
Report of Loss, Nonperformance or Damage (Est. 09/94) 25/pad
_________
DPR-ENF-013A
California Restricted Materials Requirements (Rev. 7/14)
_________
DPR-ENF-013B
Ground Water Protection List (Rev. 10/13)
_________
DPR-ENF-013C
Minimal Exposure Pesticides (Rev. 09/13)
_________
PR-ENF-016
Operator Identification Number Application (Rev. 09/09) 25/pad
_________
PR-ENF-017A
Production Agriculture Monthly Pesticide Use Report (Rev. 08/08) 25/pad
_________
PR-ENF-017B
Production Agriculture Monthly Pesticide Use Report Supplement
(Rev. 08/08) 25/pad
_________
PR-ENF-017C
Production Agriculture Monthly Pesticide Use Report (Rev. 08/08) 25/pad
_________
PR-ENF-025
Pesticide Use Report (Rev. 11/07) 25/pad
_________