Site Visit Report — Bella Terra

Site & Crew

Government project / site

Visit date

Crew on site (tap each person)

Photos — proof of visit

Take at least 5 photos of the site — camera or from your gallery.

0 of 5 minimum

📷 Take photo 🖼 From gallery

Sprinkler / Irrigation Check

Is there an irrigation system on this site?

Yes

No irrigation

Dead / dying plants to replace

Site Notes

Herbicide Applied (DOT 540-509 record)

Did you apply herbicide on this visit?

✔ Yes — sprayed

No spraying

Certified Applicator of record: Rena Bellika · Lic. 90840

Rena is the licensed applicator on every Bella Terra herbicide form. You are the operator who sprayed.

Operator — who sprayed

Equipment used

Handgun / wand nozzle Mitigation / restoration job

Prime Contractor (who Bella Terra subs under — blank if none; saved to the project)

Bella Terra is listed as the Subcontractor on the form.

Herbicides sprayed (add each product + how much was used)

Lot / batch # is the ink-jet code stamped on the jug (like NMSJRX0114) — not the front label. Tap 📷 Read lot # from photo on a row and snap that stamped code.

Target weeds (all products) Conditions at application (orange = auto-filled)

Temp °F

Wind dir

Wind mph

Sky / conditions

Start time