State of California
Department of Pesticide Regulation
FORMS REQUISITION
DPR-197 (Rev. 1/16)
Page 2 of 5
FORM NUMBER
FORM NAME
QUANTITY
DPR-ENF-030
Investigative Sample Analysis Report (Rev. 11/12)
_________
DPR-ENF-046
Enforcement/Compliance Action Summary (Rev. 01/15)
_________
DPR-ENF-047
Enforcement/Compliance Action Summary Supplemental (Est. 01/15)
_________
PR-ENF-060
Monthly Summary Pesticide Use Report (Rev. 08/08) 25/pad
_________
PR-ENF-074
Complaint of Human Exposure or Unsafe Condition (Est. 09/94) 50/pad
_________
DPR-ENF-086
Preparing for Your Administrative Pesticide Penalty Hearing (Rev. 09/15)
_________
PR-ENF-097
Pesticide Illness Investigation Request for Time Extension (Rev. 06/07)
25/pad
_________
PR-ENF-100A
Statement (Est. 03/94) 50/pad
_________
PR-ENF-100B
Statement Continuation (Est. 03/94) 50/pad
_________
PR-ENF-101
Violation Notice (Rev. 01/10) 25/pad
_________
PR-ENF-102
Pesticide Pre-Application Site Evaluation (Rev. 01/10) 25/pad
_________
PR-ENF-103
Field W orker Safety Inspection Report (Rev. 01/10) 25/pad
_________
PR-ENF-104
Pesticide Use Monitoring Inspection Report (Rev. 01/10) 25/pad
_________
PR-ENF-105
Commodity Fumigation Use Monitoring Inspection Report (Rev. 01/10) 25/pad
_________
PR-ENF-106
Field Fumigation Use Monitoring Inspection Report (Rev. 01/10) 25/pad
_________
PR-ENF-107
Structural Fumigation Use Monitoring Inspection Report (Rev. 01/10) 25/pad
_________
PR-ENF-108
Structural Use Monitoring Inspection Report (Rev. 01/10) 25/pad
_________
PR-ENF-109
Pest Control Headquarters Inspection Report (Rev. 01/10) 25/pad
_________
PR-ENF-110
Pest Control Business Headquarters Inspection Report (Rev. 01/10) 25/pad
_________
PR-ENF-111
Inspection Report / Violation Notice Supplement (Rev. 01/10) 25/pad
_________
PR-ENF-125
Application – Restricted Materials Permit (Rev. 11/07) 25/pad
_________
PR-ENF-125A
Application – Restricted Materials Permit – Supplement (Rev. 10/07) 25/pad
_________
PR-ENF-126
Notice of Intent to Apply Restricted Materials (Rev. 11/07) 25/pad
_________
PR-ENF-126X
Notice of Intent and Pesticide Use Report – Combination (Rev. 11/07) 25/pad
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