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ks dept agri reg equip license:(Make checks payable to State Board of Agriculture) KANSAS DEPARTMENT OF AGRICULTURE WEED AND PESTICIDE DIVISION STATE OFFICE BUILDING TOPEKA, KANSAS 66612 APPLICATION FOR Governmental Agency Registration and Equipment License 1, City of Salina (Print name of agency) 2. P. O. Box 746 Salina, Kansas 67401 (Address) 3. N. D. Olson, City Manager, P. 0. Box 746, Salina, Kansas 67401 (Name and address of authorized agent) Example: Mayor, City Mgr., Ch. of County Comm., Twp., Trustees, etc. 4. Equipment - Model, Make, Hp., Size. 1) Heckendorn Sprayer for 36" mower Oberdorfer 5 gpm pump, 55 gal. 2) Sun Industries Roller Sprayer Hypro 5.75 gpm 30 gal. 100 psi. (See additional sheet) 5. Names of employees who may be applying for a "Public Equipment Operators Permit". John Estes Gsarge �1='ips. Wilbur E. Thompson Milton Bender -Sid3xe�—:.-��gEjrrrst -Reber-t &ie erg Claude Henry James Hill 6. Number of units of power equipment 7 at $10 each $70.00 7. Registration fee . . $25.00 Total Registration Fee & Equipment License $95,00 8. I understand that records must be kept of all applications of pesticides and the record is to be made available to the Secretary of the State Board of Agriculture upon request. - - Date: December 5, 1972 7? Signature of Applicant -City Manager. Title t 4 _ 3) Continental Boom Sprayer 6HP 1.4 gpm @ 35 psi 200 gallon tank ser. # 125786 4) Super Lark 10 Thuron 5 HP 5 gpm @ 400 psi 16' boom or hand gun 100 gal. tank 5) Tifa 40E Fogger 9 HP 55 gal ser. #2096 6) Tifa 40E Fogger 9 HP 55 gal. ser. #1830 7) Myers Sewer Cleaner 60 HP 60 gpm/1000 psi 1000 gal. tank Application Fee and Examination Fee shall accompany this form. Checks should be made payable to State Board _of Agriculture. KANSAS DEPARTMENT OF AGRICULTURE Governmental Agency. WEED AND PESTICIDE DIVISION Calendar Year 1973 STATE OFFICE BUILDING TOPEKA, KANSAS 66612 ( ) Aerial Ground APPLICATION FOR: (1) Public Equipment Operators Permit (2) Public Equipment Operators Exam 1 Wilbur E. Thompson print name of applicant 2. City of Salina 913 827-0221 print name of governments agency; employer) Area Code Telephone 3. P. O. Box 746 Salina Ks. 67401 Governmental agency address City State Zip Code 4. Permit Fee $10.00 Examination Fee $10.00 TOTAL ..... $20.00 5, TYPE EXAM REQUESTED. (X) General, Safety, &Equipment (required) (x) Herbicides, Desiccants, Defoliants, ( Insecticides & Plant Growth Regulators ( xl Fungicides & Nematocides ( ) Rodenticides & Predators ( Horticulture (x) Aquatic A Public Equipment Operator is required to take and to pass the General, Safety, and Equipment examination. An examination covering each type of pesticide to be used is likewise required. There is no penalty for requesting and taking examinations for more types than is actually used. Applications shall be submitted at least 28 days before examination date. See your county weed control director or county extension director for details as to exam- ination dates and locations. EXAM LOCATIONS: 1st choice Salina Vo—Tech 2nd choice . (applicant shall plan to attend first choice of exam location unless otherwise notified) Application Fee and Examination Fee shall accompany this form: Checks should be made payable to State Board,of Agriculture. _ KANSAS DEPARTMENT OF AGRICULTURE Governmental Agency WEED AND PESTICIDE DIVISION Calendar Year 19_y3 STATE OFFICE BUILDING TOPEKA, KANSAS 66612 ( ) Aerial (x) . Ground . APPLICATION FOR: (1) Public Equipment Operators Permit (2) Public Equipment Operators Exam 1: John Estes print name of applicant 2.city of Salina 913 823-6621 print name of governmental agency; employer) Area Code Te ephooe. 3.. P Governmei 4. Permit Fee Box 746 Salina gency aaaress city $10.00 Examination Fee $10.00 5: TYPE EXAM REQUESTED Kansas 67401 Zip Code TOTAL ..... $20.00 (X) General, Safety, & Equipment (required) ( ) Herbicides, Desiccants, Defoliants, (X) Insecticides & Plant Growth Regulators ( ) Fungicides & Nematocides ( ) Rodenticides & Predators { ) Horticulture ( ) Aquatic A Public Equipment Operator is required to take and to pass the General, Safety, and Equipment examination. An examination covering each type of pesticide to be used is likewise required. There is no penalty for requesting and taking examinations for more types than is actually used. Application Fee and Examination Fee shall accompany this form. Checks should be made-', payable to State Board of Agriculture. KANSAS DEPARTMENT OF AGRICULTURE Governmental Agency WEED AND PESTICIDE DIVISION Calendar Year 1973 STATE OFFICE BUILDING TOPEKA, KANSAS 66612 ( ) Aerial APPLICATION FOR: (1) Public Equipment Operators Permit (2) Public Equipment Operators Exam 1 James Hill (print name of applicant 2. City of Salina (print name of government agency; employer Area Code Telephone 3. P. O. Box 746 Salina Ks 67401 Governmental agency address City State Zip Code 4. Permit Fee $10.00 Examination Fee $10.00 TOTAL ..... $20.00 5. TYPE EXAM REQUESTED (X) General, Safety, & Equipment (required) ( ) Herbicides, Desiccants, Defoliants, (x) Insecticides & Plant Growth Regulators ( ) Fungicides & Nematocides ( ) Rodenticides & Predators O Horticulture ( ) Aquatic A Public Equipment Operator is required to take and to pass the General; Safety, and Equipment examination. An examination covering each type of pesticide to be used is likewise required. There is no penalty for, requesting and taking examinations for more types than is actually used. Applications shall be submitted at least 28 days before examination date: See your county weed control director or county extension director for details as to exam- ination dates and locations. EXAM LOCATIONS: 1st choice Salina Vo -Tech 2nd choice (applicant shall plan to attend.first choice of exam location unless otherwise notified) Date: e.� r signature of aQplicant owner - employee - official titles Application Fee and Examination Fee shall accompany this form. Checks should be made payable to State Board.of Agriculture. KANSAS DEPARTMENT OF AGRICULTURE Governmental Agency WEED AND PESTICIDE DIVISION Calendar Year 19 73 STATE OFFICE BUILDING TOPEKA, KANSAS 66612 _ ( ) Aerial (x) Ground APPLICATION FOR: (1) Public Equipment Operators Permit (2) Public Equipment Operators Exam 1. Milton Bender print name of applicant) 2 City of Sa]ina agency; employer [4 3. P. O. Box 746 Salina, Ks. 67401 Governmental agency address City State Zip Code 4. Permit Fee $10.00 Examination Fee $10.00 TOTAL ..... $20.00 5. TYPE EXAM REQUESTED (X) General, Safety, & Equipment (required) (g) Herbicides, Desiccants, Defoliants, (X) Insecticides & Plant Growth Regulators () Fungicides & Nematocides ( ) Rodenticides & Predators O Horticulture ( ) Aquatic A Public Equipment Operator is required to take and to pass the General, Safety, and Equipment examination. An examination covering each type of pesticide to be used is likewise required. There is no penalty for requesting and taking examinations for more types than is actually used. Applications shall be submitted at least 28 days before examination date. See your county weed control director or county extension director for details as to exam- ination dates and locations. EXAM LOCATIONS: 1st choice Salina Vo -Tech 2nd choice (applicant shall plan to attend first choice of exam location unless otherwise notified) .Date: (signature of applicant) owner - employee official title Application Fee and Examination Fee shall accompany this form. Checks should 'be made, payable to State Board of Agriculture. KANSAS DEPARTMENT OF AGRICULTURE Governmental Agency, WEED AND PESTICIDE DIVISION Calendar Year 19 73 STATE OFFICE BUILDING TOPEKA, KANSAS 66612 ( ) Aerial (x) Ground . .APPLICATION FOR: (1) Public Equipment Operators Permit (2) Public Equipment Operators Exam 1. Claude Henry print name of applicant 2. City of Salina" print name of governmental agency; emp oyer rea Coe Te ep one 3. P. 0. Box 746 Salina. Ks. 67401 Governmental agency address City State Zip Code 4. Permit Fee $10.00 Examination Fee $10.00 TOTAL ..... $20.00 5. TYPE EXAM REQUESTED (X) General, Safety, & Equipment (required) (x) Herbicides, Desiccants, Defoliants, (x) Insecticides .& Plant Growth Regulators O Fungicides & Nematocides ( ) Rodenticides & Predators (x) Horticulture ( ) Aquatic A Public Equipment Operator is required to take and to pass the General,. Safety, and Equipment examination. An examination covering each type of pesticide to be used is likewise required. . There is no penalty for requesting and taking examinations for more types than is actually used. Applications shall be submitted at least 28 days before examination date. See your county weed control director or county extension director for details as to exam= ination dates and locations. .EXAM LOCATIONS: 1st choice Salina Vo—Tech 2nd choice (applicant shall plan to attend first choice of exam location unless otherwise