Indiana Farmstead Assessment for Drinking Water Protection Pesticide Handling & Storage

Use this survey to assess the risk to groundwater quality posed by your pesticide storage and handling practices. Circle the answer that best describes the situation of your pesticide storage system. At the end of each section sum the numbers that correspond to each answer for the section total. When you have completed the survey sum the section totals for the risk assessment score. Refer to Fact Sheet 2 for more information on pesticide handling and storage practices.

For each question, a (1) represents a higher risk to drinking water than a (3).

Mixing and Loading Practices

1. Where do you get the water that you mix with the pesticides?

	directly from well      (1) 
	tank separate from well (3)

2. What is the minimum distance between any pesticide mixing/loading
area and your well?

	less than 20 feet 	(1) 
	between 20 to 100 feet  (2)
	greater than 100 feet   (3)

3. Are all pesticide mixing/loading areas downslope from the water
well?

	Yes (2)
	No  (1)

4. What precautions do you take to prevent back-siphoning?

	permanent air gap 		(3) 
	water tank separate from well   (3)
	anti-backflow devices           (2)
	none of the above               (1)

5. Have you ever dropped a water supply hose below the fluid level in
the mixing tank?

	Yes (1)
	No  (3)

6. Is someone present during pesticide mixing and loading operations
to watch for spills and other mishaps and to take corrective action?

	present entire time    			       (3) 
	present most of the time 		       (2) 
	start filling, leave and return after set time (1)

7. Have you ever had a spill that you did not clean up?

	Yes (1)
	No  (3)

8. Are there signs such as dead vegetation that indicate chemical
movement away from the mixing/loading area?

	permanent dead vegetation 	(1) 
	some patches of dead vegetation (2)
	no signs, vegetation healthy    (3)

9. What is the condition of the mixing/loading area?

	concrete pad with curbs / no cracks, or sealed cracks (3)
	concrete pad / no curbs, no cracks 		      (2)
	no pad, soil or gravel surface 			      (1)


		Mixing and Loading Practices section total __________ 

Storage

10. Are most of your pesticides stored within 20 feet of:

	a water well?
		Yes (1)
		No  (3) 
	surface water?
		Yes (1)
		No  (3)

11. Is your pesticide storage area locked to prevent accidental valve
opening or vandalism?

	Yes (3)
	No  (1)

12. What type of floor does your pesticide storage area have?

	concrete floor 	     (3) 
	soil or gravel floor (1)

13. Are there inside drains in the pesticide storage area?

	No 				    (3) 
	Yes, drain has sump   		    (3) 
	Yes, drain runs in back of building (1)
	Yes, drain runs to city sewer       (1)

14. Do you store any cancelled or banned pesticides?

	No     					   (3) 
	Yes, store in its own secondary 
	  containment (can in a can to catch leak) (3)
	Yes, not stored in any special manner (1)

15. In case of a fire does your fire department know to let the
chemical storage area burn and not add water?

	Yes (3)
	No  (1)

		Storage section total  =  __________

Cleanup and Container Disposal

16. Where do you apply the rinsate from pesticide sprayers?

	field 				       (3) 
	farmyard, more than 100 feet from well (2)
	farmyard, less than 100 feet from well (1)

17. Where do you clean pesticide application equipment?

	field    			       (3) 
	farmyard, more than 100 feet from well (2)
	farmyard, less than 100 feet from well (1)

18. Do you triple rinse plastic pesticide containers prior to disposal?

	always    (3) 
	sometimes (1)

19. Where do you dispose of plastic pesticide containers?

	farm dump or burn pile on farm  	(1) 
	recycle or take to appropriate landfill (3)

		Cleanup and Container Disposal section total ________

Other Management

(circle Yes or No)

Do you store all pesticides together? 			Yes 	No 

Do you use containers for other purposes? 		Yes 	No 

Is the pesticide storage area clean and neat? 		Yes 	No 

Do you keep a current pesticide inventory onsite? 	Yes 	No 

Are containers marked with purchase date? 		Yes 	No 

Are materials separated by type (herbicide, insecticide)?Yes 	No 

Are pesticides stored in the original containers? 	Yes 	No 

Are pesticides stored off floor and low to ground? 	Yes 	No

Are dry formulations stored on pallets? 		Yes 	No 

Are storage areas free of spills or leaks? 		Yes 	No 

Do you have a shovel and absorbent materials readily available? 
							
							Yes 	No 

Are "Keep Out" signs posted? 				Yes 	No 

Is the storage area well-lit and ventilated? 		Yes 	No 

Is there pesticide safety equipment in the pesticide storage area? 

							Yes 	No 
Total number of Yes answers: _______ 

Total number of No answers: _______

If you had more Yes answers than No, the section total is 3; otherwise
the total is 2.

		Other Management section total _________

WARNING: Indiana has in effect regulations that govern pesticide storage. This review is not intended to identify those areas for which you are out of compliance. Contact your local extension educator for details on these regulations.

Risk Assessment for Pesticide Handling and Storage

Add the following totals:

Mixing and Loading Practices section total ____ x 4 	= ________ 

Storage section total ____ x 3 				= ________ 

Cleanup and Container Disposal section total ____ x 2 	= ________ 

Other Management section total 				= ________


	Survey 2 Score  ________________


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	Low	       	    Moderate			High
     198 - 151		    150  - 99		       98 - 64
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Click below for Fact Sheet 2

Pesticide Handling & Storage Fact Sheet