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All available forms and documents are arranged by Division and, except where noted, stored in Adobe pdf format. View pdf documents with Adobe Acrobat Reader. If your document is not listed please call (661)868-6300 or e-mail the Division Deputy to request a copy. |
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PHYTOSANITARY CERTS |
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CANADA ORIGIN
CERTIFICATE |
Canadian Food Inspection Agency Certificate of Origin for counties NOT regulated for LBAM (includes Kern County). |
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CDFA QUARANTINE
COMPLIANCE CERT. |
Certificate of origin and treatment (if applicable) for commodities shipped from or through Kern County. |
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FEDERAL PHYTO -
ATTACHMENT FORM |
Official Federal Phytosanitary Certificate Attachment Sheet (Form PPQ 575). |
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FEDERAL PHYTO -
MS EXCEL TEMPLATE |
Microsoft Excel template for completing Federal Phytosanitary Certificates (Form PPQ 577). |
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FEDERAL PHYTO -
SUPERCEDE FORM |
Request to replace a previously issued Federal Phytosanitary Certificate. |
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PCIT |
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| PCIT FACT SHEET |
USDA Phytosanitary Certificate Issuance and Tracking (PCIT) System – Industry Fact Sheet. |
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USDA ADMIN FEE |
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CHECKS COLLECTED
WORKSHEET |
Log for tracking the USDA Administrative Fee remitted in check form (for shippers using 4-part paper).
Corrected Address 11/24/09 |
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| KERN COUNTY MEMO |
Kern County memo providing information on the USDA Administrative Fee collection process and exemptions for voided phytos. |
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PHYTOS ISSUED -
INSTRUCTIONS |
Instructions for completing the USDA Administrative Fee worksheet. |
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PHYTOS ISSUED -
WORKSHEET
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Log for tracking Date, Applicant, and Certificate Number for issued Federal Phytosanitary Certificates (for shippers using 4-part paper). |
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| USDA MEMO |
USDA Administrative Fee announcement and information. |
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APIARY |
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| BEE MOVEMENT |
Pin or unpin apiary locations for the Department's pesticide notification system. |
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| BEE REGISTRATION |
Beekeeper registration, apiary location(s), and request for pesticide notification. |
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PERMIT - CONDITIONS |
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| ALDICARB |
Aldicarb inventory, purchase history, recommendation records, and invoice requirements. |
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| DRIFT MINIMIZATION |
Aircraft and ground drift minimization measures for restricted materials. |
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| GENERAL |
Kern County 2010 General Permit Conditions (Effective January 1, 2010). |
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GWPA -
MANAGEMENT |
Runoff and leaching management practices for Ground Water Protection Areas (GWPA). Includes pesticides subject to restriction and all classified Kern County GWP Areas (listed by TRS). |
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GWPA -
NON-PRODUCTION |
Supplemental conditions for GWP Area materials when used at non-production and/or non-agricultural sites (non-site specific use). |
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METAM SODIUM/
POTASSIUM |
Approved metam application methods, NOI requirements, and acceptable and prohibited times/locations. Includes the Kern County Fumigation Summary form. |
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| PHENOXY |
Allowed dates and restrictions for phenoxy applications. |
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| TELONE |
Overview, application methods, and background information for 1,3-Dichloropropene pesticides (fumigants). |
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| THIODAN |
Runoff containment and conditions for endosulfan aerial applications. |
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PERMIT - GENERAL |
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LETTER OF
AUTHORIZATION |
Authorization for anyone other than the permittee (the operator of the property, defined as the owner, partner or officer of the business applying for the permit) to sign the permit. |
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| PERMIT SUPPLEMENT |
Application for a Restricted Materials Permit supplement. |
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PERMIT - RESPIRATORY PROGRAM |
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| MEDICAL QUESTIONNAIRE |
Questionnaire for completion by each respirator-wearing employee. |
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MEDICAL QUESTIONNAIRE
SPANISH |
Questionnaire for completion by each respirator-wearing employee. SPANISH VERSION |
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| PROCEDURES |
Respirator selection, fit testing, training and evaluation for an organization's Written Work-Site Specific Procedures. |
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| TRAINING FORM |
Employee respirator assignment, fit test, training record, and consultation
(Written Respiratory Protection Program - Attachment #1). |
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| VOLUNTARY POSTING |
Posting requirements for voluntary respirator use. |
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VOLUNTARY POSTING
SPANISH |
Posting requirements for voluntary respirator use. SPANISH VERSION |
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| WORKSITES WITH IDLH |
Supplemental program documentation for use of atmosphere-supplying respirators and work in IDLH atmospheres.
(Written Respiratory Protection Program - Attachment #2). |
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MISCELLANEOUS |
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| INFORMATION REQUEST |
Environmental and Public Protection Division information request. Use for Restricted Materials Permit and use report data requests. Note: Permit and use report data may be directly downloaded from our website. |
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NOI PILOT PROJECT
CONTACT PREFERENCES |
Kern County grower contact phone and e-mail preferences for the Department's Notice of Intent Pilot Project to Protect Agricultural Workers. |
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| PERMIT DOWNLOAD INSTRUCTIONS |
Instructions for downloading and viewing 1994 through current Restricted Materials Permit data. |
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| USE REPORT DOWNLOAD INSTRUCTIONS |
Instructions for downloading and viewing 1994 through current Pesticide Use Report (PUR) data. |
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