The AGR Form 640-4234 is the official Washington State Department of Agriculture pesticide application record. It was developed by the WSDA Pesticide Management Division to standardize recordkeeping for commercial residential ornamental and lawn applicators across the state.
Washington State law under chapter 17.21 RCW requires applicators to complete this form on the same day as each pesticide application. Records must be retained for a minimum of seven years. WSDA inspectors may request access to these records at any time during that period.
The form collects the following information for each application: the date, the name and license number of the commercial applicator, the pesticide product name and EPA registration number, the active ingredient and concentration, and the total amount applied. It also captures environmental conditions including wind speed, wind direction, and air temperature at the time of application, along with the address and size of the treated area.
Maintaining accurate records on this form protects applicators in the event of an inspection or complaint. It also supports public and environmental safety by creating a verifiable record of what pesticide was used and under what conditions. For related Washington State agricultural recordkeeping, see the AGR Form 702-4279 and the WSDA Form Record.
| Question | Answer |
|---|---|
| Form Name | Agr Form 640 4234 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | Qts, adjuvants, AGR, agr form 640 4234 |