Annual Notification

Download PDF

The District has adopted an Integrated Pest Management (IPM) policy. This policy includes notifying parents/guardians of pesticide use. During the school year, it may be necessary to apply pesticides at your child’s school to avoid serious health problems posed by pests and/or maintain the integrity of a structure. However, should you feel that your child’s or your (for school staff) health and/or behavior could be influenced by exposure to pesticide products, you are notified as follows:

-An application of products on the Approved List may be applied during the school year (see attached list of pesticide products that have been approved for use at District sites).
ƒ-In the event the use of a product is required that is not on the Approved List, you will be notified 72 hours in advance. (Exception: Emergency circumstances that warrant an immediate response).
-Additional information regarding pesticide products, including those on the District’s Approved List, is available online at http://www.cdpr.ca.gov

Please complete, detach and return the form below to the school’s main office, indicating whether you wish to be pre-notified each time a pesticide is scheduled to be used at the school.

====================Cut here and return if applicable=================

__I signed up directly for email notifications at http://www.ipmnotice.info/parents to be notified every time a pesticide application is to take place at my child’s school in addition to this annual notificaiton. I understand that the notification will be made via email at 6pm three days prior to the application. Emergency notificaiton will be made as soon as possible following the applicaiton of the pesticide.

__I would like to be notified every time a pesticide application is to take place at my child’s school in addition to this annual notificaiton. I understand that the notification will be made via email at 6pm three days prior to the application. Emergency notificaiton will be made as soon as possible following the applicaiton of the pesticide.

__I do not need to be notified every time a pesticide applicaiton is made at the school. I understand that I am receiving this annual notification today.

Child’s Name:_____________________________________________

Room Number: _______________

School:____________________________________________________

Name of Parent:____________________________________________

Email Address:_____________________________________________

Signature of parent/guardian:__________________________ Date:_________

Below is a listing of all the pesticides which may possibly be appliced at the school for this school year.

Pesticide Active Ingrident EPA Number
Gojo Goop g33
Round UP Isopropylamine salt of glyphosate 59240