Professional Documents
Culture Documents
2.
3.
4.
5.
6.
(a)
(b)
area----------------------------------------------------------------------
(c)
-----------------------------------------------------------------------------------------7.
8.
9.
2.
pesticides hereunder on the premises situated at ----------------------------------------- under the supervision of the following expert
staff;
Name: ----------------------------
Qualification:
----------------
----------------------------
----------------
----------------------------
----------------
Name of product
Active Ingredient
Concentration
(G/kg or Lt)
-------------------
-------------------
----------------
-------------------
-------------------
----------------
-------------------
-------------------
----------------
Co-secretary
Pesticide Registration Board
3.
4.
5.
6.
Brief
description
of
technological
process
including
2.
Address of Company/Enterprise:-----------------------------------------------------------------------------------------------------------------------------
4.
----------------------------------------------------------------------------------------5.
No.-----------------------------------------------------------------------------6.
------------------------------------------------------------
Signature of applicant
-----------
(2)
(3)
9. Date of permit: ---------------------------------------------------------------10. Expire Date: ---------------------------------------------------------------------
Co-secretary
Pesticide Registration Board
Application Form
2.
3.
4.
11.
-----------------------------------------------------------------------------------------2.
3.
4.
5.
The address, of the premises in which the pesticides will be repacked, stored and distributed: --------------------------------------------(a)
(b)
(c)
6.
7.
8.
----------------------Signature of applicant
2.
U/Daw
----------------------
National
Identity
Card/
national
Qualification:
----------------
----------------------------
----------------
----------------------------
----------------
Name of pesticide
Active Ingredient
Concentration
Package
(g/kg or Lt)
Size
-------------------
-------------------
---------------
--------
-------------------
-------------------
---------------
--------
-------------------
-------------------
---------------
--------
Secretary
Pesticide Registration Board
(2)
(3)
(4)
13.
14.
The Co- secretary will evaluate the field inspection report and will
summit to the Pesticides RegistrationBoard.
15.
16.
2.
3.
4.
5.
(b)
Area; --------------------------------------------------------------------
(c)
6.
7.
------------------------------------------------------------------------------------------
2.
3.
4.
District Officer
Department of Agriculture