Pesticide Application Regulatory Compliance Audit

General Information

Audit Date Auditor Name Site/Location Responsible Person

Pesticide Information

Pesticide Name	Active Ingredient(s)	Manufacturer	Product Registration #	Batch/Lot #

Application Details

Date of Application	Applicator Name	License/Permit #	Area Treated	Application Rate	Equipment Used

Compliance Checklist

Compliance Area	Compliant	Comments
Proper labeling and storage	Yes No N/A
Pesticide approval/registration	Yes No N/A
Certified applicator	Yes No N/A
Record-keeping up to date	Yes No N/A
Personal Protective Equipment used	Yes No N/A
Adherence to REI/PHI	Yes No N/A
Environmental protection measures	Yes No N/A

Findings / Non-Conformities

Corrective Actions

Additional Notes