Iowa Admin. Code r. 21-45.28
The department shall issue a temporary certificate to private applicators for a single purchase of restricted use pesticides in situations declared to be an emergency by the department, upon receipt of the following completed and signed affidavit. No person shall use a restricted use pesticide without first complying with the requirements for applicator certification outlined in subrule 45.22(7).
21—45.28(206) EMERGENCY SALE OF A RESTRICTED USE
PESTICIDE BY A PRIVATE APPLICATOR
Emergency Single Purchase of Restricted Use Pesticide—Affidavit.
The Label which I have read, indicates:
Brand name of pesticide:
Federal Registration Number:
Name of Active Ingredient(s):
Percentage of Active Ingredient(s):
If the pesticide product is to be mixed with a carrier, show the amount of pesticide product per gallon of tank mix:
Application rate per acre:
Name pest to be controlled:
At what stage of development is the pest most easily controlled:
State degree of hazard (signal word):
Describe safety equipment required:
What is the recommended antidote for this product:
List environmental precaution shown on label:
Length of time until re-entry, if given:
Preharvest interval days required:
Describe method of container disposal:
I wish to make purchase of this pesticide on (date)
and I hereby swear under penalty of perjury that I understand the above label information and warnings.
_________________________________________
(name of private applicator)
This rule is intended to implement Iowa Code sections 206.4 and 206.5.
[ARC 9145C, IAB 4/30/25, effective 1/1/26]