Fill this out only if you are City and County of San Francisco staff requesting an exemption to use a pesticide product that is:

1) not on the current San Francisco Reduced-Risk Pesticide List, OR

2) listed on the current San Francisco Reduced-Risk Pesticide List, BUT for a use that is not in the list's "Use Limitations" column, OR

3) listed in the current San Francisco Reduced-Risk Pesticide List, BUT for a use that is not allowed in the "Site-Specific Rodenticide Limitations."

Also use this form if you are applying for an exemption from posting requirements. Enter "NA" in inapplicable fields.

Please allow at least 3 days for your request to be processed.

For questions, view the IPM Compliance Checklist or call Shoba Iyer, SF Dept. of Environment at (415) 355-3759.

What you write below is public information and will be posted on our website.

- BE CONCISE

- USE CORRECT GRAMMAR & SPELLING

Do not hit the BACK button in your web browser or you may lose the info provide in this form. After you click SUBMIT, you'll get an email with all the info you provided.