IN THE MATTER OF



SAMPLE FIRE DEPARTMENT LETTER FOR PESTICIDE STORAGEDate Fire Department NameStreet AddressCity, State Zip CodeRE: Pesticide Storage NotificationTo Whom It May Concern:Enclosed please find the pesticides currently stored, or may be stored during the coming year, at the location indicated below. I am required by the State of New Jersey, Department of Environmental Protection, Pesticide Control Program, per Regulation N.J.A.C 7:30-9.5(b), to provide the local Fire Department a Pesticide Storage Inventory List annually by May 1.The listed pesticides (on Page 2) are stored at:Legal business/farm name: Facility address: Street AddressCityState Zip CodeThe exact location of the pesticide storage area at the above listed property is (provide a written description and/or a diagram): If you should have any questions or comments, please contact (contact name) at (XXX) XXX-XXXX or via e-mail at .Sincerely,SignatureTitleLegal business/farm name: Facility address: Street AddressCityState Zip CodePESTICIDE STORAGE INVENTORY LISTProduct Brand NameActive Ingredient(s)EPA Registration NumberALL PESTICIDES CURRENTLY STORED, OR MAY BE STOREDIN THE COMING YEAR, MUST BE LISTED ON THISPESTICIDE STORAGE INVENTORY LIST.THIS LIST SHALL BE POSTED ON SITE IN A CENTRAL LOCATION (ONLY APPLICABLE FOR WPS REGULATION REQUIREMENTS).Sample Fire Department Letter for Pesticide StorageDATEFire Dept NameADDRESSCITY, STATE, ZIPRE: Pesticide Storage AreaTo Whom It May Concern:Attached please find a list of pesticides that are stored or likely to be stored at [name of business/farm (and address if not on letterhead)]. The actual storage location is [describe storage area/location or include diagram]. This list has been sent to comply with state Pesticide Control Regulations found at N.J.A.C. 7:30-9.5(b), and it will be updated annually and sent to you by May 1st of each year.If you have any questions regarding this letter, please call [contact person] at [phone number.]. Thank You, Name TitlePesticide Inventory ListPESTICIDE BRAND NAMEACTIVE INGREDIENT(S)EPA REG. NUMBER(Example) Gordons Super TrimecMCPP, Dicamba, 2,4 D 2217-758ALL PESTICIDES CURRENTLY STORED, OR MAY BE STOREDIN THE COMING YEAR, SHALL BE LISTED ON THISPESTICIDE STORAGE INVENTORY LIST.THIS LIST SHALL BE POSTED ON SITE IN A CENTRAL LOCATION (ONLY APPLICABLE FOR WPS REGULATION REQUIREMENTS). ................
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