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The forms available in this page are for downloading & printing. Data is not sent to us by you filling in these forms. The fill-in feature is provided for your convenience only so you can fill-in and print. Thank You.


AgBulletPesticide Use Enforcement

Complaint of Human Exposure or Unsafe Condition

Complaint of Human Exposure or Unsafe Condition Form. Please print this form, fill it out and fax or mail to our offices.

Training & Worker Safety Forms
Pesticide Handler Written Training Program (English & Spanish) 
Fieldworker Safety Training Program (English & Spanish) 
Field Posting Requirements and Signs 
Restricted Pesticide Permits and Operator ID's
Permit Application/agcomm/images/pdfxsm.gif 
Authorized Rep FormpdfSmall 
California Restricted Pesticides chartpdfSmall 
Private Applicator Certificate ApplicationpdfSmall 
Site map form 
Methyl Bromide Worksite Plan Packet/uploadedImages/pdfxsm.gif 
Methyl Bromide Permit Conditions/uploadedImages/pdfxsm.gif 
Pest Control Business Licensing
QAC/QAL/PCA exam schedule / Applications/uploadedImages/pdfxsm.gif 
Application and Use Records
Request to Inspect / Review Records /uploadedImages/pdfxsm.gif 
Production Agriculture Monthly Use Report (PR-ENF-017C) /uploadedImages/pdfxsm.gif 
Monthly Summary Pesticide Use Report (PR-ENF-060) /uploadedImages/pdfxsm.gif 
Pesticide Use Report (PR-ENF-025) /uploadedImages/pdfxsm.gif 
Notice of Intent (PR-ENF-126X) - Must be submitted 24 Hrs before application /uploadedImages/pdfxsm.gif 
Multiple Site / Commodity Pesticide Use Report /uploadedImages/pdfxsm.gif 
Structural Pest Control Business Forms
Structural Registration Branch I /uploadedImages/pdfxsm.gif 
Structural Registration Branch II & III /uploadedImages/pdfxsm.gif 

AgBulletPest Exclusion

Nursery Forms
Nursery Application Form /uploadedImages/pdfxsm.gif 
Phytosanitary Certificate Request
Phyto Request Santa Maria Office (print & fax) /uploadedImages/pdfxsm.gif 
Phyto Request Santa Maria Office (save, fill & email) wordSmall 
Phyto Request Santa Barbara Office /uploadedImages/pdfxsm.gif 

Quarantine Certificate Request

QC Request Santa Maria Office /uploadedImages/pdfxsm.gif 
QC Request Santa Barbara Office /uploadedImages/pdfxsm.gif 

Certified Producers' Certificate Application

Please Read BEFORE submitting Application /uploadedImages/pdfxsm.gif 
Regulations Summary /uploadedImages/pdfxsm.gif 
Application & Map /uploadedImages/pdfxsm.gif