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iE <br /> 4 PPP <br /> SAN ,iGACUIN COUNTY <br /> 1868 E . HAZEL70N AVENUE <br /> STOCK ON , CA 95205 <br /> Office : (209)468-3300 Reccrter (NOT ) : (209)465-3300 FAX : (209)468-9330 <br /> RESTRICTED MATERIALS PERMIT Permits : 39-02-390:674 <br /> County HQ District* : - <br /> V & V FARMS Expiration Dame : 12/31/20:.2 <br /> P O BOX 2244 Ef f_ctive Date //v1o2-1 <br /> LODI , CA 95241- <br /> LOSE VIRAMCNT S Home : (209)367-5=71 <br /> 328 MAPLE ST Shc= : 209)941-54.34 <br /> LODI , CA 95240- Fax : <br /> Mobile : (209)4a2-6806 <br /> Permittee Type Permit Type Possession NCI Methcc ct Submission <br /> - - <br /> Private App [Q Seasonal [X] Poss & Use EXj Phone___--_ � _-_ <br /> :<_ Fax____-I <br /> Q A Cert [ J job Poss Only [ Bax `?_ Mader _ <br /> Ag PCO [ _n Person [X: <br /> �- Non-Ag [ ] NOT required 241 hours prior to applica for <br /> Numb- Pesticide P4- App (s) <br /> �.st-s' Farm. Method(z) -A .,= cater s <br /> I I --------------- <br /> ------------ <br /> -- ---------------- ---- -- <br /> 1051 SEVINLARVAE Licuic Ground PCC Grower <br /> ! 1360 CHLOROPICRIN NEMATODE Fumigant Ground PCS: Growe-- <br /> 3141 GUTHION MITES Liquid Ground PCC Grower- <br /> 3850 METHYL BROMIDE SOIL/STOPED Fumigant Ground PCO Grower <br /> 9801 2 , 4-D AMINE WEEDS Liquid Ground PCO Grower <br /> 16011 PARAQUAT WEEDS Liquid Ground PCC Grower <br /> �-- 16891. SUPRACIDE LARVAE Liquid Ground PCO Grower <br /> 18571 NEMACUR NEMATODE Fumigant Fumigate PCO Grower <br /> Non-Ag Use: <br />` Conditions : PQW <br /> I understand that-this-permit rices-not- relieve-me-from-liability for anydamage <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 /> E 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 uses <br /> in the treatment . [Perm PR-EN F-125 (Rev. 07/92) Pesticide Enforcement Branch] <br /> Permit Applicant: I 94,iof Sign: /� <br />! Title. Date'. L, 6r- <br /> Issuing Officer: Date: 0 � <br />