[email protected] • Phone: 1.800.529.1980

Transcription

Name
Title 1
Title 2
Phone: (123)456-7890
Ext: 1
Fax: (123)456-7890
Cellular: (123)456-7890
Mobile: (123)456-7890
Address 1
Address 2
City, AK 12345
Email
www.cropproductionservices.com
New safety
items now
available on
our website
2016
PRINT & PROMOTIONAL PRODUCTS CATALOG
Email: [email protected] • Phone: 1.800.529.1980
CONTACT INFORMATION
WEBSITE: WWW.ASBACES.COM/NEWACES/CPS.ASPX
American Solutions for Business
Email: [email protected]
Phone: 1.800.529.1980
Fax: 1.303.648.5518
We will beat
any previous
suppliers price
by 11% on all
new jobs*.
Dee Ann Anderson
1.800.529.1980 ext. 10
John Letzelter
1.720.988.6734
Free Ground
freight in
contiguous
United States
on all custom
promo and
apparel orders*.
CPS Contact
Lorraine Mahaffey
[email protected]
CPS - National Account Manager
1.970.685.3306
*some conditions apply - call for details
American Solutions for Business is one of the top print and
promotional products companies in North America. While
many of our orders are produced on demand and shipped
direct, we also store items in our warehouse for immediate
release (invoice paper, BOL’s etc…………as well as many
promotional products).
HATS
OUR MOST POPULAR HATS
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JIT AND APPAREL
APPAREL - JUST IN TIME PROGRAM
No Minimum on Most Apparel Items.
Free Ground freight on all Custom Promotional Product orders.
We have 1000’s of Apparel choices - please see the Apparel Catalog on our website
for our best sellers – if you cannot find what you need, please give us a call!
Orders ship in 7-10 days. Rush service available. Call for more details.
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JIT AND APPAREL
APPAREL - JUST IN TIME PROGRAM
Columbia, Nike, Port Authority and much much more! We can get
about every line of clothing. Please call if you can’t find what you
need, and let us do the searching for you!
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COMPANY STORE
PROMOTIONAL ITEMS IN STOCK FOR IMMEDIATE RELEASE!
CPS8004
CPS8007
CPS8008
CPS8008C
Letter Opener
Stadium Blanket
Hat
Camo Hat
CPS8008M
CPS8009
CPS8010
Mesh Hat
Flashlight
Can Koozie
CPS8010CAMO
PO
#
RR
37
31
8-
09
1
:0
15
4/
/1
08
SO
6
B1
O
P:
A
Camo
Can Koozie
1
3
08
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oS
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r
3 P /4
8
69
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:6
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Ar n Pr Pt e W vail
Ad ree um Lin t A
Sc inim um s No
M inim ne
M lfto
Ha
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R:
O
OL
TC
IN EEN
R
P R
IM 1 G
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CPS8011
CPS8012
CPS8013
CPS8014
Mug
Cross Pen
Bic Pen
Bic Pen
)
ns
io
vis __
re
_
te ___
a
c
_
di
__
(in
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IS
OF ___
AS PRO ___
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ed
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v
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o
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pr
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an
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Ap ISE
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RE URE
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SIG
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COMPANY STORE
CPS8018
CPS8019
CPS8020
CPS8021
Rain Gauge
Calculator
Golf Balls
Mouse Pad
CPS8022
CPS8023
CPS8024
CPS8026
Double wall Tumbler
2QT Pitcher
1PT Pitcher
Nylon Flag
CPS8027
CPS8028
CPS8028
CPS8029
Mat 3’x4’
Windsock 8”x36”
Windsock 18”x72”
Windsock Bracket
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COMPANY STORE
CPS8032
CPS8034
CPS8037
CPS8040
Ground Flag
Business Card Jotter
Pocket Knife
USB Auto Charger
CPS8041
CPS8042
CPS8043
CPS8044
Chip Clip
Thermos
Lunch Tote
Wall Clock
CPS8046
CPS8047
CPS8048
CPS8049
CPS8050
Micro Cloth
Tape Measure with Level
Tissue Pack (20)
Spiral Jotter
Junior Padfolio
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COMPANY STORE
CPS8052
CPS8054
CPS8057
CPS8059
24oz Sports Bottle
Large Sports Pack
Clip on Light for Hats
Phone Card Sleeve
CPS8065
CPS8066
Lipbalm
Multi-Tool
Device Charger - comes with
micro USB cord
CPS8088
CPS8128
CPS8129
CPS8130
Ceramic Mug
Mudflap 24”x30”
Sharpie
Canopy Tent
CPS8069
CPS8070
Flashlight
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CPS SAFETY
SAFETY APPAREL & EQUIPMENT
CHECK OUT OUR WEBSITE FOR MORE SAFETY APPAREL
AND EQUIPMENT!
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CPS SAFETY
CPS WORK BOOTS
TBO1054A
TBO87566
TBO88117
TBO91636
TBO92615
TBOA11NW
BOOTS ARE STOCKED –
SHIP WITHIN 24 HOURS!
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CPS SIGNAGE & DECALS
WE PRODUCE MANY, MANY VERSIONS OF CUSTOM SIGNAGE AS WELL
47.75”
To: WorkFlowOne
Date: 10-30-08
Our Order #:
Your Order #:
Description: Small Building Sign
OK as is...proceed with order
Small Building Sign
Part # CPS5120
OK with revisions
Make changes as indicated
and submit revised proof for approval
35"
Precision
Precision
Placement
Placement
®
®
78"
Pantone 4545
Pantone 3308
Building Signs
Crop Signs
Banners
WE CAN PRODUCE
SIGNS/DECALS
IN CUSTOM
SIZES/DESIGNS.
Diecut Aluminum
Logos for Walls
CALL US FOR MORE
DETAILS!
To: WorkFlowOne
Date: 10-30-08
Our Order #:
Your Order #:
Description: Door Decal Green
OK as is...proceed with order
Door Decal
Part # CPS5101
OK with revisions
Make changes as indicated
and submit revised proof for approval
24.75"
Decals
Tank Decals
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Pantone 3308
Square cut/DieCut – All sizes
Call us for details
Sail Signs
TRUCK DECALS
TRUCK AND EQUIPMENT DECALS
CPS5100
CPS5101
Door/Equipment Decal White
Door/Equipment Decal Green
Custom Decals are available - made to any size,
any quantity. Contact us for more details.
USDOT 1203339
USDOT 1203339
CPS5140
CPS5141
DOT Door Sign - White
DOT Door Sign - Black
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SIGNAGE & DECALS
CPS5120
Metal Sign 78”x35”
CPS5200
Coroplast Sign
CPS5121
LPI5130
CPS5205
Coroplast Sign
CPS5000
Neon Sign
Custom sizes and designs
available.
Call us for more details.
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SIGNAGE & DECALS
DYNA5242
DYNA5000
Neon Sign
DYNA5130
DYNA5133
Metal Sign 30”x20” - We can
imprint farm name in white box.
DYNA5200BCORN
Coroplast Sign
DYNA5200BCPS
Coroplast Sign
DYNA5200BL
Coroplast Sign
DYNA5138
Metal Building Sign 35”x78”
72”
1.875”
48”
DYNA-PROOF
On Farm Evaluation
1.875”
18” To Center
DYNA5139
Dyna-Gro on Farm Plot Sign
Coroplast - 36”x60”
4 HOLES - .375” DIAMETER
18” To Center
DYNA5140
Dyna-Gro Metal Sign with
Wood Frame 48”x72”
DYNA5156
Dyna-Gro Bin Decal 72”x25”
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DYNA-GRO ITEMS
SOME ITEMS ARE IN STOCK FOR IMMEDIATE RELEASE!
Cooperator Name:
Crop:
Year:
Mailing Address:
Division
City:
ST:
County:
Rate:
Pre Herb 2:
Rate:
Pre Herb 3:
Rate:
Post Herb 1:
Rate:
Prev Crop:
Post Herb 2:
Rate:
Post Herb 3:
Rate:
Insecticide:
Rate:
Soil Type:
Fungicide:
Soil Color:
Comments on Plot:
Brand
Trait
Air Temp:
SoilTest:
Starter
Post
Total
Rank
Tst
Harvest
%Stalk
%Root
$/Acre
Wgt.
Pre
Pop.
Lodge
Lodge
P lbs/ac:
K lbs/ac:
Avg. Rainfall:
S lbs/ac:
Zn lbs/ac:
Foliar:
SCN:
Micro:
Soil pH:
Rate:
# Buffer Rows:
Hybrid
Fertility:
N lbs/ac:
Soil Temp:
Pre Herb 1:
Row Width:
Tillage Type:
Entry
No.
Sales Rep:
Prior Year Herb:
Planting Pop.
Harvest Date:
C
h
e
c
k
Location:
Zip:
Telephone:
Planting Date:
Irrigation Type:
Other:
O.M. %
Row Direction:
of Field
Plot Starts On
Seed
#
Row
Harvest
%
Treat.
Rows
Length
Weight
Mst.
Rank
Yield
Yield
$ /Acre @
GPS Location:
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I hereby grant to Agrium, its agents, successors and assigns, the irrevocable, non-terminable right to use my name, photograph and attached comments without any claim to compensation. My signature indicates that I have been told and understand how these
materials will be used. I also agree that Agrium may make slight stylistic modifications to my comments which do not materially alter the original meaning.
COOPERATOR
DATE
REPRESENTATIVE
DATE
Grain Yield = (100-moisture) x (lbs. Of grain) x (factor) / (Row length in feet) / (Row width in inches) / (Number of rows)
Crop
Corn (15%)
DECALS
All Sizes and
Applications
APPAREL
PRECISION PLACEMENT
Factor:
109.814
Crop
Soybeans
Factor:
100.138
Crop Factor:
Grain Sorghum 108.538
Crop Factor:
Sunflowers 5805
Crop Factor:
Silage 7.467
Page______ of ______
DYNA1000
DYNA1001
Seed Order Form
Planting Harvest Form
®
On Farm Evaluation
DYNA5130
All Sizes and
Materials
DYNA5240
DYNA5241
DYNA8001
DYNA8002
Coroplast Sign
Sign
Papermate Pen
16oz Tumbler
DYNA8007
DYNA8024
Calculator
DYNA8025
DYNA8026
Rain Gauge
Hat
Nylon Flag
DYNA8130
Canopy Tent
PLEASE CHECK OUT THE DYNA-GRO CATALOG ON OUR WEBSITE
OR CALL US FOR MORE DETAILS
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LOVELAND PRODUCTS
LOVELAND PRODUCTS BANNER STANDS
CANVAS PRINTS
LPI5010
LPI5011
Window Cling
Treatment Board Kits
LPI5013
LPI5016
Titan Vinyl Magnetic Decal
Matador Window Decal
LPI5054CITRUS
LPI5054CORN
Citrus Gallery
Canvas
Corn Gallery
Canvas
LPI5054COTTON
LPI5054VINE
Cotton Gallery
Canvas
Vineyard Gallery
Canvas
LPI5054SOY
LPI5054WHEAT
Soybean Gallery
Canvas
Wheat Gallery
Canvas
LPI5054ALMOND
LPI5054VEGGIES
Almond Gallery
Canvas
Veggies Gallery
Canvas
Innovative biochemical fertilizer catalyst
formulated specifically for
impregnation onto dry fertilizer blends
Highly concentrated biochemistry
to enhance applied nutrient availability
Always read and follow label directions. Check State Registration to make sure product is registered in your state.
© 2014 Loveland Products Inc. All Rights Reserved.
LPI8130
Canopy Tent
Cross Pen
Need More Product Information?
Click on the above QR Code
Bannerstands
25+ Versions on our
website
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SEED TREATMENT
NEW SEED TREATMENT CATALOG NOW ON OUR WEBSITE
THESE LOGOS ARE NOW AVAILABLE FOR EMBROIDERY
ON ALL ITEMS
ITEMS AVAILABLE WITH LOGOS PRINTED IN COLOR – MINIMUMS DO APPLY
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CONTRACTOR SAFETY
ACKNOWLEDGEMENT PROGRAM
SEE IT! FIX IT!
REPORT IT!
Date:
Time:
YES
Occurred on Premises:
NO
Exact Location of Event:
Risk Potential:
SEE IT:
Low
Medium
High
Description:
NEAR MISS - UNSAFE ACT
NEAR MISS - UNSAFE CONDITION
Communication: not timely, misunderstood, shift change, contract or 3rd party
coordinator
Mistakes: fatigue, distracted, overloaded, bored, mental slip, human error
Self-Responsibility: Horseplay, in a hurry, shortcut, poor decision
Supervision: inadequate preparations, pre-job review, follow-up, worker selection,
coaching discipline
Training: not done, not developed, did not attend, inexperienced, did not recognize risk
or hazard
Work Direction: Did not follow rules/procedures, improper tool, improper use of
equipment
3rd parties: customers, growers, suppliers, contractors, visitors, neighbors, general
public
Equipment: failure, unreliable, tools, design, parts, materials, machines, controls,
alarms
Internal procedures: not used/followed, wrong, followed incorrectly
Maintenance: poor housekeeping, wear and tear, not inspected or tested, needs
improvement
NaturalEvents:weather,wind,heat,flood,fire,wildfire,insects
Plants and property: construction, siting, layout, congestion, deteriorated, beyond
useful life
Standards and Practices: inadequate drawings, permits, licenses, manuals, signs, labels
Work Environment: lighting, noise, ventilation, hot/cold, wet/slick, unsanitary
CPS1026
FIX IT:
Action Taken:
Report It:
Reported By:
CPS1027 (11/15)
CPS1027
CPS2488
CPS2600
APPENDIX B
CONFINED SPACE ENTRY PERMIT
LINE BREAKING PERMIT
This permit must be posted on job site••good only on indicated dates
Guest Card
Please sign the visitor sign in log and
observe the requirements below.
Minimum personal protective equipment (PPE) required
outside the office or any designated safe zones.
• Long pants and shirts with sleeves
• Work boots
• Class 2 high visibility clothing or vests
• Safety glasses
• Have access to appropriate type of glove for the work
being conducted
Emergency Information
• In the case of an emergency proceed to the
predesignated assembly area as referenced in the
Emergency Action plan.
*If any activity is conducted outside of the guest definition
in the Safety Acknowledgement Procedure then a Contract
and Contractor Acknowledgment forms are required.
CPS1021
CPS1021
Elevated Work Permit
Excavation Work Permit
Scope of Work:_____________________________________________________
This permit must be completed and posted at the jobsite daily by the
company’s Competent Person. The compentent person must inspect
prior to the start of work and as needed throughout the shift.
Area of Elevated Work: _____________________________________________
Employees/Contractor Involved: ____________________________________
Fall Protection Plan Reviewed
Employee Training
Start Date/Time: _________________ End Date/Time: __________________
Manager: _______________________ Supervisor: ______________________
Type of Equipment in Use:
Scaffolding
Ladders
Elevated Platforms/Catwalks
Scope of Work:_____________________________________________________
Contractor: _________________________________________________________
Supervisor/Crew Lead: _____________________________________________
Location of Excavation: _____________________________________________
Approx. Size/Depth: ________________________________________________
Start Date/Time: _________________ End Date/Time: __________________
Elevating Equipment
Mobile Equipment
Other:_________________________________________________________
Fall Protection Method Used: _______________________________________
Name of Competent Person: ________________________________________
Signature of Competent Person: ____________________________________
Soil Classification: __________________________________________________
____________________________________________________________________
List equipment and method for Shoring and/or Benching as required
by the Competent Person:
Type of Fall Protection Equipment Used: ____________________________
____________________________________________________________________
____________________________________________________________________
CPS1022 (12/15)
CPS1023 (6/15)
_______________
Job Site / Space Identification:
Authorized Entrants
_____________________________________________
Authorized Attendants
_______________________________
_______________________________
_______________________________
_______________________________
EMERGENCY PHONE NUMBERS (Including In-House Extensions And/Or Radio Numbers)
Local Fire Department
_______________________ ________________________
Local Rescue squad
_______________________ ________________________
Local Hospital
_______________________ ________________________
TEST(S) TO BE TAKEN
(Time / Result)
(Time / Result)
Oxygen-min
> 19.5%
_______ _______
H2S
Oxygen-max
< 23.5%
_______ _______
Toxic (specify)
Flammability
> 10%lel/lfl
_______ _______
Tester Initials
_________
_________
Permit Space Hazard Identification
Indicate ALL potential hazards of this permit space
a. Contains or may contain hazardous atmosphere
Yes
No
b. Contains a material potential for engulfment
Yes
No
c. Has an internal configuration for potential entrapment
Yes
No
If yes, describe:
_______________________________________
d. Contains the following recognized serious safety
or health hazards:
Other
< 10 ppm
Material normally in line:
Starting time and date:
Ending time and date:
_______
_______ ________
_______ ________
_________
__________
Mandatory Safety Equipment Required
Specify as required
PPE (ex, respirator, goggles, protective clothing, boots, etc.):
___________________________________________
Respiratory Protection:
___________________________________________
Atmospheric Testing / Monitoring:
___________________________________________
Communications:
___________________________________________
Rescue Equipment (ex, chest harness, wristlets, etc.)
___________________________________________
Lighting Equipment:
_______________________________________
___________________________________________
Other:
_______________________________________
___________________________________________
CPS1024 (7/2015)
CPS1023
(Retain Permit for 6 Months from Issuance)
Line to be broken:
Purpose of Entry: _______________________________________________________
_______________________________________
____________________________________________________________________
CPS1022
Permit No.: ___________ Facility: _____________ Entry Supervisor:
Date: _____________ Time of Issue: _____________ Permit Duration: ______________
Hazard Present (check all that apply)
Toxic
Irritant
Asbestos
Flammable
Rust, Scale, Dirt
Hot
Corrosive
Gas, Toxic
Pressurized Line
Actions Required (check all that apply):
Isolated Line / Lockout Valves
Remove Combustible Material
Depressurize Line
Electrically Ground Line
Drain / Evacuate Line
Hot Work Permit Needed
Flush / Purge Line
Secure Line From Falling
CPS1025 (7/2015)
CPS1024
CPS1025
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CPS STATIONERY ITEMS
CPS FORMS AND DOCUMENTS
Phone: (123)456-7890
Ext: 1
Fax: (123)456-7890
Cellular: (123)456-7890
Mobile: (123)456-7890
Name
Name
Title 1
Name
Name
2
Title 1
Name
Title 1
Address 1
Address 2
City, AK 12345
Title 1
Title 2
Title
2
Title 2
1
Title
Title 2
Email
Phone: (123)456-7890
Ext: 1
Phone: (123)456-7890
Phone:
Fax: (123)456-7890
Ext: 1
Phone: (123)456-7890
Ext: 1
Cellular:
Fax: (123)456-7890
Ext: 1
Fax: (123)456-7890
(123)456-7890
Mobile:
Cellular:
Fax:
(123)456-7890
Cellular:
(123)456-7890
Mobile: (123)456-7890
(123)456-7890
Cellular:
Mobile: (123)456-7890
Address 1
Mobile: (123)456-7890
2
Address 1
1
City, Address
AK 12345
Address
2
Address
1
2
City, Address
AK 12345
2
City, Address
AK 12345
Email
City, AK 12345
Email
Email
Email
CPS
Agrium
Dyna-Gro
Business Cards
Business Cards
Business Cards
Title 1
Title 2
Add 1
Add 2
City, SC Zip
Address 1
Address 2
City , NE 12345
(t): (970) 534-3440
(f): (970) 356-8926
(c): (970) 381-7403
Anna Lisa Angerami
Regulatory Affairs &
Services Specialist
PO Box 1286
Greeley, CO 80632
(e): [email protected]
seed treatments
www.lovelandproducts.com
Address 1 • Address 2 • City , NE 12345
Phone: 123-456-7890 • Fax: 123-456-7890 • Mobile: 123-456-7890 • Email
LPI - Standard
Envelope
Envelope
Business Cards
6x9
#10
Letterhead
3333 S. Bannock St.
Suite #1000
Englewood, CO 80110
Address 1
Address 2
City, AK 12345
Address 1
Address 2
City, SC Zip
CPS122
#10 Custom Envelope
Envelope
9x12 Custom Envelope
For ARS Invoices
For ARS Invoices
9x12
Address 1
Address 2
City, AK 12345
Add 1
Add 2
City, SC Zip
Add 1 • Add 2
City, SC Zip
TO:
Window Envelope
Envelope
#10
10x13
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Mailing Labels
CPS8017
Custom Notepad
CPS FORMS & DOCUMENTS
CPS BILL OF LADING (BOL) PAPER
1000 SETS PER CARTON
1000 SETS PER CARTON
750 SETS PER CARTON
750 SETS PER CARTON
CPS2100P
CPS2101P
CPS2102P
CPS2103P
ARS Order/BOL Paper
ARS Order/BOL Paper
ARS Order/BOL Paper
ARS Order/BOL Paper
XEROX MODEL - PAPER TYPE - STRAIGHT VS. REVERSED
7220/7225 – REVERSE PAPER
3615DN – REVERSE PAPER
58XX – STRAIGHT PAPER
(BLANK SIDE UP, TOP TOWARD BACK OF MACHINE)
(BLANK SIDE DOWN, TOP TOWARD FRONT OF MACHINE)
(BLANK SIDE UP, TOP TOWARD FRONT OF MACHINE)
CPS2101P – 3 PART REVERSE
CPS2100P – 3 PART STRAIGHT
3655/6655 – STRAIGHT PAPER
WC5855 – REVERSE PAPER
75XX – STRAIGHT BOL PAPER
(BLANK SIDE DOWN, TOP TOWARD BACK OF MACHINE)
(BLANK SIDE UP, TOP OF PAGE TOWARDS FRONT OF MACHINE)
4622 – REVERSE PAPER
6605DN – REVERSE PAPER
78XX – REVERSE PAPER
(BLANK SIDE UP, TOP TOWARD BACK OF MACHINE)
RICOH MODEL - PAPER TYPE - STRAIGHT VS. REVERSED
SP8300DN – STRAIGHT
C3003 – STRAIGHT
MP301SPF – STRAIGHT
(BLANK SIDE UP, TOP OF PAGE TO THE RIGHT)
(BLANK SIDE UP, TOP OF PAGE TOWARDS BACK OF MACHINE)
5210DN – REVERSED
C3503 – STRAIGHT
SP5210SF – REVERSED
(BLANK SIDE DOWN, TOP OF PAGE TOWARDS FRONT OF MACHINE)
(BLANK SIDE DOWN, TOP OF PAGE TOWARDS FRONT OF MACHINE)
C306 – STRAIGHT
C5503 – STRAIGHT
MP5002SP – STRAIGHT
20
CPS FORMS & DOCUMENTS
CPS FORMS AND DOCUMENTS
Date: ________________
Time: ________________
Name:______________________________________________________
Time: ________________________
Product
A.M.
P.M.
Qty.
Price
CPS1012 (06/09)
CPS2000
CPS1012
CPS1100
Order Pad
ARS Invoice Paper
Can only be ordered by Divisional Office
ORDER FORM
Packing TickeT
ACCT. NO.:
❑ Prepaid
Order Confirmation Form
______________
DATE RECEIVED:
SHIPPING OR DELIVERY DATE:
Prod.: __________________________________
CPS2016
Hand Ticket
___________
SALESMAN NO: ___________ TERMS: ___________
____________________________________________________
❑ Prepay & Charge
❑ Collect
CUSTOMER ORDER NO.: ________________________________________________________
SOLD TO:
________________________________________________________________
DESTINATION:
SHIP TO:
Lot no.: ________________________
______________________________________________________________
_________________________________________________________________
DESTINATION:
______________________________________________________________
ROUTE AND DELIVERING CARRIER:
___________________________________________________
_______________________________________________________________________
SPECIAL INSTRUCTIONS:
QTY.
________________________________________________________
PACKAGE SIZE
PRODUCT
PRICE
Pallet no.: ______________________
Date: ___________________________________
Signature: _____________________________
CPS2031 (ASB 11/11)
ORDER RECEIVED BY:
CPS2206 (12/08)
_____________________
FROM:
______________________________
CPS2031
CPS2488
CPS2206
CPS4005
Pallet Ticket
Hot Work Permit
Order Form
Cass Info Label
CPS Application Order Form
•
Goshen (Florida), NY
•
845-651-5303
Date:
Customer:______________________________________
Farm/Address: _______________________________________________________
Total Acres: Corn: _________________ Hay: _________________ Vegetables: ___________________
Phone: __________________________________
Customer: _______________________________________________ Phone: _______________________
PRODUCT / SERVICE
ACRES
RATE/A
TOTAL PROD.
CASH
WORK ORDER
Crop Production Services, Inc. • LuVerne, Iowa • 800-682-2965 • 515-882-3234
Pre-Pay / Pricing Order Form
Crop Production Services, Inc.
Date: ______/______/______ Farm:_________________________________________________________
CORN Acres:
INVOICE
Pre-Pay
PRODUCT
TOTAL COST
Date:
“Profit From Our Experience”
ACRES
RATE ACRE
TOTAL/GAL.
Booking
COST/GAL. COST/ACRE TOTAL COST
Applicator:
CPS
Order-Taker:
Grower Name:
Farm Name / Special Instructions:____________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Crop Data:
BEAN Acres:
TOTAL AMT. FOR CORN: $
28% GPA _________________
Dry Fertilizer
Corn
Soybeans
Corn Stalks
Acres
N
Planted: Date _________________
Product:
Chemicals
Hay Ground
Soybean Stubble
P
Pasture
K
Not Planted
Lime
GPA
Pounds Per Acre:
Total:
Rate Per Acre:
Total:
11 - 52 - 0
0 - 0 - 60
46 - 0 - 0
18 - 46 - 60
ESN
Price Good Through: ______/______/______
TOTAL COST: $
Pesticides:
Customer Signature:
Signatures:
CPS Salesman Signature:
Customer:
CPS2210 (1/09)
CPS Rep:
Date:
TOTAL AMT. FOR BEANS: $
TOTAL COST: $
CPS2244 (06/09)
CPS2239 (06/09)
CPS2210
CPS2239
CPS2244
CPS6014
Pre Pay Order Form
Application Order Form
Work Order
Expense Envelope
21
REFILLABLE CONTAINER DECALS
REFILLABLE CONTAINER - LABELS AND FORMS
CPS4002
CPS4015
“This Drum Contains”
RCRA Tank Label
REFILLABLE CONTAINER
LOG FORM
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Did the “Last
Contained” Label on
the container say,
“Non Refillable
Container”?
If Yes, then container
may not be refillable
and must be
recycled.
Were the Tamper
Evident Devices in
place? If No, then
container must be
triple rinsed prior to
refilling
YES
YES
YES
NO
NO
NO
YES
YES
YES
Was the
container
Triple-Rinsed
prior to this
re-filling
operation?
DOT Container Last
Inspection Date.
If Past 30 Months,
Re-Inspect Container
Container
Identification Number
(Bar Code)
NO
NO
NO
YES
YES
YES
NO
NO
NO
YES
YES
YES
NO
NO
NO
YES
YES
YES
NO
NO
NO
YES
YES
YES
NO
NO
NO
YES
YES
YES
NO
NO
NO
YES
YES
YES
NO
NO
NO
YES
YES
YES
NO
NO
NO
YES
YES
YES
NO
NO
NO
/
/
/
/
/
/
/
/
/
/
Must log repackaging information into ARS System
Refill Date
Product Name
Product EPA
Registration
Number
Total Gallons
filled into
container
Month / Day / Year
Month / Year
1 0 0 0 ___ ___ ___ ___ ___ ___
1 0 0 0 ___ ___ ___ ___ ___ ___
1 0 0 0 ___ ___ ___ ___ ___ ___
1 0 0 0 ___ ___ ___ ___ ___ ___
1 0 0 0 ___ ___ ___ ___ ___ ___
1 0 0 0 ___ ___ ___ ___ ___ ___
1 0 0 0 ___ ___ ___ ___ ___ ___
1 0 0 0 ___ ___ ___ ___ ___ ___
1 0 0 0 ___ ___ ___ ___ ___ ___
1 0 0 0 ___ ___ ___ ___ ___ ___
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
Any questions call MOC or refer to Compliance Manual
CPS2022 (ASB 7/11)
CPS4022
CPS2022
CPS4023
Container Identification Decal
Refillable Container Log Form
Tamper Service Fee Decal
SERVICE CONTAINER
CPS4025 (ASB 08/11)
CPS4024
CPS4025
Refillable and Nonrefillable Decal
Service Container Decal
22
South
Jason Street
1885715
West
Dartmouth
Ave, Unit 16
Denver, COCO
80223
Englewood,
80110
A
B
C
D
E
CUSTOM SCALE TICKETS
WE HAVE OVER 200 VERSIONS ON FILE
CUSTOMIZED WITH BRANCH INFO
CANVAS PRINTS
CALL US FOR MORE DETAILS
...SEND US YOUR VERSION AND
WE WILL RE-PRODUCE IT FOR YOU!
F

[email protected] • Phone: 1.800.529.1980

Transcription

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