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SU0006822 SSCRPT
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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
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Supplemental fields
FilePath
\MIGRATIONS\H\HAZELHURST\18406\PA-0700506\SU0006822\SSC RPT.PDF
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EHD - Public
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186S E. HaZELT tiv AVER CE <br /> STOi T`N, —A 95205- <br /> -rr.aW: Well:a'u x.Cn sm,;ea,yli:.czxuj'ATgco!l <br /> Office: (309)468.33011 Fax: (309)468.3330 Recorder ENTOPa): (z0>A63-3-3W <br /> L <br /> RESTRICTED-MATERIALS I'ERM11" <br /> DE PALMA FARMS INC, A D P Pennit Numb4r: 39-06-39031 <br /> 68 <br /> L 18666 E TTWY 120 <br /> Courtly D-mct ft- F <br /> RIPON, CA.95356- Expiration Date: December 31, 2006 <br /> Effective Date: January 3, 2006 <br /> L <br /> DON1:NIC DEPAL A. Rom-Phone-, tbW5"14-4207 <br /> L18666 E IfWY 120 Shop Phone: (20-0)8--28-7034 <br /> PIPON, CA 95366- Mbbtle Phone: (209}531-78.51 <br /> Fax. (2091838-8011 <br /> 6. Petr2ittee Type: Private Applicator NOI li effi.ed of Submission: <br /> Permit Type: seasonal Phoa-r: X FWc X Bor. X <br /> th. Possession: Possession&Use In Person: X Modern: X 'Web: X <br /> NCH required 24 hours Prior to amlication, <br /> L <br /> Conditions: N P,Q,W.GWP-L3 <br /> See end of cennit rnr <br /> GOdL deELRt3GIDIli. <br /> LI urid=rstsrcl[hat this permit doea not relieve me from liability fcri arrr damages to any persons ar property caused <br /> by t=he use of these pesticides. T waive any claims of liability for damages against the County Department.of <br /> Agriculture based on the issuance of this permit I further mderstand that this permit maybe revoked where <br /> Lpest-1--ides:are used in labeling or in violations of applicable lavas,regulations md <br /> aF:et f c conditions of frits per reit I authorize inspection at all reasonable limes and whenever an emere-my exist:. <br /> by v¢ie Deeartrnent of Pesticide ReW datior,car the Cvilrity Department.of Agr;culture of all am s <br /> Q71y'7')PeE^i_ideErtfi~r�=enP_entBY"atCTi� <br /> treated or tobe <br /> treated,stora&e facilities for pesticides or emptied coritainers and equipment used orto heuitheteamrr <br /> 6. For, PP?FNF-125 (Rev. <br /> L PernutApplicalf b0 AQ inlirSigned: <br /> Wlea.e rr:[�; <br /> Title_ /)IJA).,/L Issue Date: ZL. /d(, <br /> (please ' t� <br /> =_; "g O"6-'t. Issue Irate: <br /> ho <br /> 7 <br /> d <br />
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