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U <br /> SAN JOAQUIN COUNT---.- <br /> 2101 E EA.RHR.T- SUITE 100 <br /> STC' I`CN,CA 95206- l <br /> Web:WWW.co.san-joagtun.ca.uslagcornm <br /> Office: (209)353-6000 Fax: (2�J9)953-6022 Rea rder(NOI`s):(209)953-6000 <br /> R OTIND VAT.T.RV R ANC;T-TFq P it Number• 39-11-3904457 <br /> P 0 ROY W Gouty Disixict 9. F <br /> VTCTC)R CA 957.53 Expiration DaW December 31, 2011 <br /> Effective Date- <br /> 0-1 <br /> TC}N T FTAW F MORF Home Phone: (7,09 1676RDI <br /> 115 N 9C;FTOM. KT IqTTTTF. 5 Shap Phone: 000)169_601 <br /> T.OT)T CA 95740- MoWePhone: f7.0914RI_0011 <br /> Fax: 0.019110)JM11 <br /> Penwiftee Type: Private pplica-for N01 Meffied alr Sub missiun: <br /> Petu it T;tee: Renaattal Phone: 5f Fax:3I Box: <br /> Possession: Possession &Use In Person: Y Web:x ModenE <br /> ICI reauirect 24 hours Vrior to auuiicaticn- <br /> Gtrndi.4aam: A,OVJP-L3,C'rV4P-R3,P,S,W See end of permit for <br /> code descriptions. <br /> ------------------------------------------------- <br /> I understand that this purnit dws not r ehoje me from liability for any damages to sny persmis cr propa-ty caused <br /> by&,e use of these pesticides I waive any claims of liability for damages agsir,4 the County Department of <br /> Agriculture based m etre issumce of this permit I furore-understand that this perinit maybe revolted when <br /> pesticides are used in conflict with the rmrtufac=ees labeling trr in violation of applicable laws,regulations and <br /> specific cmttrditicrm of this permit I authorize inspectim at all ressor►able times and whenever an emErgency exists <br /> by the Depm-armwit of Pesticide Regulation or the County Dep mtmea of Agriculture of all areas treated cr to be <br /> treated,storage Eacilities fcr pesticides ear sn.Vtied contain and equipment used or to be used in the treatment. <br /> I have considwM alternatives.and rnitigatim measures pury ant to Title 3,Califbmia Code of Regulations,section 0426 <br /> Walking into accan3t eccnamic,envirc mEntal,mcial,and technological factors,I have adopted those that are feasible <br /> and would substantially lesser,.any significant adverse impact m the envirmunent <br /> [><o rra PR-ENF-125 (Rev. 11106)Pesticide Er-,forcemerrt Branch j <br /> Pet t Applica,at: 1-J/ �!��t r� \14cA-"irk SignL�.- <br /> Tease Print) <br /> Title: �tl` Isere F1ste: <br /> (Please ) JJ Q <br /> IsstJf&cer Issue Date:t ! �Z 10 o <br />