Please read the following document. Once you have  understood your rights and responsibilities, please complete the form at the bottom of this page and click the Submit Button. We will pick up the signed hardcopy when we visit to begin your service. NJ DEP 2006 Document Dear Customer: As of November 19,2001, The New Jersey DEP Pesticide Control Program instituted a new program that requires us to provide customers with information about the materials that we will be using as part of the pest control program for your property. We are using this consumer information sheet to provide you with this information. Below on this sheet lists any label precautions for the pesticide that you should be aware of. We will apply the pesticides listed below to your property within Within the dates listed. Proposed Date Brand Name Chemical Name of Application Merit IMDACLOPRID DO NOT ENTER TIL DUST HAS SETTLED May to August. Chaser Ultra DIMETHYLAMINE SALT DO NOT ALOW PEOPLE AND PETS ON ENTER TREATED AREA TIL THE SPRAY HAS DRIED(SPOT SPRAY FOR BROADLEAF WEEDS) April to November Dimension Dithiopyr DO NOT ENTER TIL DUST HAS SETTLED(CRABGRASS CONTROL) March to May You will also notice that, following each application, at least one sign will be place on your property that says PESTICIDE TREATED AREA and contains the international signage for " Keep Off Grass". We are required to do this as part of the new program. The signs must remain in place for 72 hours following the application. We would appreciate if you would remove the sign before the end of the 3 day period following the application . As the customer, You should also be aware that you may request notification of the exact dates of our applications and for a copy of the label for each pesticide that we will use. We are also required to provide the following phone numbers for your use in the event you have any health related questions concerning the materials that we will be using: New Jersey Poison Information & Education System 1-800-222.1222 N.J. DEP 609-984-6507 National Pesticide Network 1-800-858-7378 CGM Inc. 856-582-3582 CGM NJ DEP Pesticide Application License No. 29597A Pesticides are chemical substances used to control living organisms and vary to degree of toxicity. Pesticides may be part of a good pest control program. Sanitation, as well as physical and biological control measures, should be considered as another part of a good pest control program. CUT HERE AND RETURN BOTTOM OF THIS FORM ------------------------------------------------------------------------------------------------------------------------  As the customer, I hereby certify that CGM Inc. has provided me, in writing, all the information required under the NJDEP Pesticide Control Program’s notification program. I have read the information supplied and understand my rights and responsibilities under this program. I also agree to remove the notification signs that they will post on my property, no sooner than 72 hours following each application . Signed:_______________________ Date:____________   I certify that I have read and understand the above document: Select Yes or No *    Select Yes or No Yes No Name *  Address *  Telephone * E-mail   * = required field After submitting your certification, you will be returned to our Home Page!