Printable Version of Annual Initial Pesticide Notification Signup Form

Dear Parent, Guardian, and School Staff:

New York State Education Law Section 409-H, effective July 1, 2001, requires all public and nonpublic elementary and secondary schools to provide written notification to all persons in parental relation, faculty, and staff regarding the potential use of pesticides periodically throughout the school year. The West Genesee Central School District is required to maintain a list of persons in parental relation, faculty, and staff who wish to receive 48-hour prior written notification of certain pesticide applications. The following pesticide applications are not subject to prior notification requirements:

  • a school remains unoccupied for a continuous 72-hours following an application;
  • anti-microbial products;
    nonvolatile rodenticides in tamper resistant bait stations in areas inaccessible to children;
  • nonvolatile insecticidal baits in tamper resistant bait stations in areas inaccessible to children;
  • boric acid and disodium octaborate tetrahydrate;
  • the application of EPA designated biopesticides;
  • the application of EPA designated exempt materials under 40CFR152.25;
  • the use of aerosol products with a directed spray in containers of 18 fluid ounces or less when used to protect individuals from an imminent threat from stinging and biting insects including venomous spiders, bees, wasps, and hornets.

In the event of an emergency application necessary to protect against an imminent threat to human health, a good faith effort will be made to supply written notification to those on the 48-hour prior notification list. If you have not yet registered to receive 48-hour prior notification of pesticide applications that are scheduled to occur in your school, please complete the form below and return it to the West Genesee Central School pesticide representative at: (insert address, telephone, e-mail address, and FAX).

This is also available at the top of this webpage in a pdf format that you can download and fill out.

West Genesee Central School District Request for Pesticide Application Notification

School Building Name:

Name:

Address:

Day Phone:

Evening Phone:

E-Mail Address:

Please feel free to contact the West Genesee Central School District pesticide representative at: Ken Coon at 5301 West Genesee Street, Camillus, NY 13031, (315) 487-4630, kcoon@westgenesee.org, and FAX (315) 487-2786 for further information on these requirements, including information on products that are scheduled to be applied in this school.

If you have any trouble accessing the PDF documents on this page, please contact the Publications Office at publications@westgenesee.org or call (315) 487-2179.