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Resend Emailed Report (If Applicable)
request for roadside spraying
page_1
Date:
First Name:
Last Name:
Phone Number:
Weeds:
Absinth Wormwood
Black Henbane
Hoary Cress
Houndstongue
Diffuse Knapweed
Russian Knapweed
Spotted Knapweed
Leafy Spurge
Palmer Amaranth
Purple Loosestrife
Saltcedar
Canada Thistle
Musk Thistle
Dalmatian Toadflax
Yellow Toadflax
Select all noxious weeds in infested area.
Description of infestation location:
Example: South side of 52nd St. SW between 80th Ave. SW and 81st Ave. SW.
GPS Location:
Use Current Location
Clear
< defs>
LAT
LNG
ALT
ACC
Photo:
Clear
NOTE: Photos work best if taken in landscape view
Email:
*
C45weed@hpeprint.com
Must be selected for our office to receive printed report.
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