This government document is issued by Department of Pesticide Regulation for use in California
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https://www.google.com/url?client=internal-element-cse&cx=001471602751020418307:yrct1_ri5_y&q=https://www.cdpr.ca.gov/docs/schoolipm/school_ipm_law/hsa/forms/hsa-annual-notification-form.pdf&sa=U&ved=2ahUKEwiIsfOg4JSJAxUPgf0HHTOKEpU4ChAWegQICRAB&usg=AOvVaw1frlOp8v_gIQV9xZMass_h