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SU0006822 SSCRPT
EnvironmentalHealth
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SU0006822 SSCRPT
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Last modified
5/7/2020 11:32:44 AM
Creation date
9/5/2019 11:02:45 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0006822
PE
2622
FACILITY_NAME
PA-0700506
STREET_NUMBER
18406
Direction
S
STREET_NAME
HAZELHURST
STREET_TYPE
RD
City
ESCALON
APN
24508007
ENTERED_DATE
11/7/2007 12:00:00 AM
SITE_LOCATION
18406 S HAZELHURST RD
RECEIVED_DATE
11/6/2007 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\H\HAZELHURST\18406\PA-0700506\SU0006822\SSC RPT.PDF
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EHD - Public
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L <br /> SJsi JOf,QUIN C.i_1.NTY <br /> Y <br /> 1?c c � �AZELTON AVENUEL <br /> :>1Oc;l_l'013. CA 95205- <br /> LWeb URL :www . r_o . san-ioaquin . ca us/agc_Emm <br /> E-mail <br /> office : ( 209 ) 468-3300 Recorder (NOI ) : ( 209) 468-3300 FAX: ( 209 ) 468-3330 <br /> ------- -------------- -----ee <br /> ESTRICT'ED MATERIALS PERMIT PERMIT # : 39-04-3903068 <br /> County H ry :District B <br /> DE PALMA FARMS INC. . A.D.P . Expiration Date : 12/31/2004 <br /> 19666 E 14WY 120 Effective Date 01/01/2004 <br /> RIPON. CA 9536r,- <br /> DOMINIC DE PALMA Home : ( 209 ) 544-4207 <br /> 19666 E tinY 120 Shop : ( 209)838-7034 <br /> RIPON . CA 95365- Fax: 20983580/1 <br /> Mobile . ( 209) 531-781 <br /> tri <br /> Termittee Type Permit T�Jpe Possession NOI Method of Submission <br /> -------------------------- <br /> ---- ---- <br /> rivate App IXI Seasonal IXI Poss & Use IXI Phone IXIFax IXI <br /> 4 A Cert I I .Sob I I Posa only I I Box IXI Modem I I <br /> !Ig PCO I I POO Only I_i In Person IXI Web IXI <br /> Non-Ag I I NOI required 24 hours priorto application <br /> Non-Ag Use: None <br /> onditions : A , P :.3 <br /> Sec end of permit for <br /> code descriptions . <br /> 8 understand that this permit does not relieve me fr'orrr liability for any damage <br /> persons- or property caused by the use ., pest-icideo f I waive any <br /> based on the issuance of this permit . I further uncerstan.- that this permit <br /> av be revoked when pesticides are used in conflict with the manufacturers <br /> L{{ abeling or in violation of applicable laws , regulations and specific <br /> c,nditiors of this permit . I authorize inspection at all rea=sonable times and <br /> whenever an aznergency exists . by the Department of Pesticide Regulation or the <br /> -ounty Department of Agr'icultur'e of all areas, treated or to be treated. storage <br /> L .1cilities for pesticides or emptied containers and equipment used or to be used <br /> n the treatment . (Form PR-ENF-125 (Rev . 07/92 ) Pesticide E -arc e t Branch] <br /> eraniT. Applicant - /M1 IC -iqn : ] — <br /> Title : iss'uE mate: 4z G3 <br /> ,, Jj <br /> II Issuing Officer : ' e'er Z.. sue Date : /-t/� � <br /> Page <br /> L <br /> 6 <br /> L <br />
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