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k <br /> 1 ! A t <br /> SAN JOAQUIN COUNTY <br /> 1868 E_ HAZELTON AVENUE <br /> STOCKTON, CA 95205 ��!C?03 <br /> 1 Uffice_� (209)468-3300- Recorder (NOI) : (209)468-3300 <br /> FAX: (209)468-3330 <br /> RESTRICTED MATERIALS PERMIT- <br /> Permit#: 39-02-3902061. <br /> County HQ District#: J <br /> ELISSAGARAY, ROGER Expiration Date: 12/31/20 <br /> 1505 E VALPI CO 12/31/209700 <br /> 'TRACY CA Effective 'Date <br /> , 95376-- 01/29/2002 <br /> ROGER ELISSAGARAY <br /> 1505 E VALPICO Home: (209)832-3252 <br /> TRACY, CA 95376- Shop: <br /> Fax: 630-6844 <br /> Mobile:. (209)484--7250 <br /> Fermittee-Type ^- Permit Type--^-=possession_ =-_=--NOI Method of- ubmission <br /> S <br /> --___-�.__ __ _ _ ___ <br /> _ _ <br /> Private APP [X] Seasonal [X] Poss & Use^[X] Phone T__________________ <br /> Q A . Cert C ] Jab [ ] Poss Only C ] Box [X] Fax [X] <br /> Ag PCO [ } [X] Modem [X] <br /> Non-Ag [ In Person [Xa <br /> NOI-required 24 hours prior to application <br /> Numb Pesticide Pest(s) - - Form. --Method(s) AT_l - -__-_- <br /> - _ <br /> 1360 CHLOROPICRIN NEMATODEFumigant Ground- - PCO _ _ Grower--- <br /> 3141 GUTHION MITES Liquid Air Ground PCO Grower <br /> 3830 METHOMYL LARVAE Liquid Air Ground PCO Grower <br /> 3850 METHYL BROMIDE SOIL/STORED Fumigant Ground PCO Grower <br /> 3940 METHYL PARATHIO LARVAE Liquid Air Ground PCO Grower <br /> 4840 ALUMINUM PHOSPH RODENTS Fumigant Ground PCO Grower <br /> 5540 STRYCHNINE GOPHERS Bait Ground PCO Grower <br /> 16011' PARAQUAT WEEDS Liquid Ground PCO Grower <br /> 16891 SUPRACIDE LARVAE Liquid Air Ground PCO Grower <br /> Non-Ag Use: <br /> Conditions: PW <br /> I understand that this permit-doesYnot�relieve Tme from liability for any damage <br /> to persons or property caused by the use of these pesticides. I waive any <br /> claim of liability for damages against the County Department of Agriculture <br /> based on the issuance of this permit. I further understand that this permit <br /> may be revoked when pesticides are used in conflict with the manufacturer's <br /> labeling or in violation of applicable laws; regulations and specific <br /> conditions of this permit. I authorize inspection at all reasonable times and <br /> whenever an emergency exists, by the Department of Pesticide Regulation or the <br /> County Department of Agriculture of all areas treated or to be treated, storage <br /> facilities for pesticides or emptied containers and equipment used or to be usei <br /> in the treatment. [ orm PR-EAT 5- (Rev. 07/92) Pesticide Enforcement `Branch] <br /> Permit Applicant: Sign: <br /> Title: �f Date: <br /> Issuing Officer: Date : <br />