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SAN JOAQUIN COUNTY <br />| , <br />� 1868 E. HAZELTON AVENUE �4 <br /> STOCKTON, CA 95205 <br />� <br /> FO-fice-. (209)468-3300 Recorder (NOI ) : (209)468-3300 FAX : (209) 468-3330 <br /> ' <br /> RESTRICTED MATERIALS PERMIT PERMIT/OPERATOR l ~D. #: 39-98-3900133 <br /> [^ County HQ District #: H <br /> EMERSON; JIM Expiration Date: 12/31/2000 <br /> 10062 E [OMSTOCK RD Issue Date-. <br /> i STOCKTON, CA 95215- ^^�xu11 ^, = <br /> � . <br /> JIM EMERSON Home: (209)93i-1785 <br /> E10062 E COMSTOCK RD Shop: ( ) - <br /> STOCKTON, CA 95215- Mobile: ( )466-2534 <br /> ================================================================================ <br /> FOR RESTRICTED MATERIALS PERMIT USE ONLY <br /> h Permit Type: Poss. Only [ ] SeaAonal [X] Poss. & Use 03 Job [ ] <br /> Permittee Type: D.A. Cert [X] Ag . PC[] [ ] Private App [ ] Non-Ag [ ] <br /> NO! required 24 hours prior to application ' <br /> "-Method: Phone [X] Box [X] Person [Xl Modem [ ] Fax [X] <br /> Numb Pesticide Rest(s) Form. Method (s) Applicator(s) <br /> F1051 SEVIN Larvae Liquid Air Ground PCO Grower_________ ____________ --------- ________________ _________7________ <br /> 1360 CHLOROPICRIN Nematode Fumigant Ground PCO Grower <br /> 2591 THJODA�� Larvae Liquid Ground PC! Grower <br /> t <br /> 3141 GUTHION Mites Liquid Air Grcund � PCO Grower <br /> ` 3830 METHOMYL Larvae Liquid Air Ground PCO Grower ' <br /> 3350 METHYL BROMIDE Soil/Stored Fumigant Groudd PCO Brower <br /> F3940 METHYL PARATH3O Larvae Liquid Ground PCO Grower <br /> 4840 ALUMINUM PHOSPH Rodsnts Fumigant Ground PCO Grower <br /> 5540 STRYCHNINE Gophers Bait Ground PCO Grower <br /> P6260 ZINC PHOSPHIDE Rodents Bait ' Air Ground PCO Grower <br /> � 9801 2,4-D AMINE Weeds Liquid Air Ground PCO Brower <br /> '^ 16011 PARAQUAT Weeds Liquid Air Ground PCO Grower <br /> 16B9l SUPRACIDE Larvae Liquid Air Ground PCO Grower <br /> ~ ~ <br /> Non-Ag Use: <br /> Conditiontx F`QUW <br /> I understand that this permit does not relieve me from liability for any damage <br /> to persons or property caused by the use of these pesticides. I waive any <br /> A claim of liability for damages against the County Department of Agriculture <br /> ` ' based on the issuance of this permit. J further understand that this permit <br /> may be revoked when pesticides are used in conflict with the manufacturer' s <br /> k labeling or in violation of applicable laws, regulations and specific <br /> U- 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 /> FCounty Department of Agriculture of all areas trsated or to be treated, storage <br /> faoiliQ85 for pesticides or emptied containers and equipment used or to be <br /> used in the treatment. [Form 33-125/v3.53 (Rev. 02/16/90) Pesticide Enforcement <br /> f� Br"nohl <br /> C�LPermit Applicant Sign : <br /> Title-r~ Date: <br /> IssuingOfficer: Date: <br /> F <br /> | <br /> / <br />