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�VEINUE -' <br /> 95205 FAX �2{�9j4��Q-333o <br /> �fice� (2O9)4�R^330O Recorder ( �{�I ) : (209)4�8-33OO : ������:�����=� <br /> 39-01~39OO115 <br /> County HQ District#: D <br /> Ex�piration Ds^te: 12/31/2001, <br /> �ELUCCH� , MICKHEL <br /> Z795 S HOLLENBECK RD <br /> �CCKTO�� CA 952�5- <br /> "� �ome: {2O9}465-OY84 <br /> �ICH4EL �EL�CCHI Shop: <br /> -795 S HOLLE�42ECK RD Fax : <br /> CA 95205- <br /> Met�od of Submission <br /> rmi'tee <br /> �� ----~------- ^-~--'---� � [ ] <br /> ---------'-'- P & i� e [X] Phone [X] ax <br /> Private App [X] Seasonal [X] oss s [X] <br /> A C�rt [ � Job [ � Poss Unly L � 8oxperson [X] <br /> Lg PCO required 24 hpurs prior to application <br /> M thod�s) Applicator�s) <br /> LAM Pestic�de Pest(s| <br /> Form <br /> ~e~~____~,__-,-_ <br /> w� ------ -`-'----~-~- --�� G r <br /> ---~ ---~----- 8 d PCO rowe <br /> LARVAE Liguid Air roun " � <br /> 1051 SEVI% NEMAT[}�E Lipuid Air Ground PCO Grower <br /> /}61 FOPADAN pC8 �rower <br /> NEMATODE <br /> Fu�igant Gro�nd <br /> 6�360 CHLOROPICRIN ' �d Air �round PCO Growzr <br /> 2O00 D1CAMGA WEEDS --qu d pCO Sro�er <br /> SYgT�N AP��ID Liquid Air Grovn S er <br /> - G :d PCC rrw <br /> ( i i� Air rou ~ - <br /> 591 Ti�IODAN �MRVAE - qu ~ ~ �`[O Grower <br /> ��141 GUTHION �ITES Li�u�� Air �round ,�� Sro*er <br /> � 24 METAGYS��X R D Li�uid Air 8round F� G <br /> 38 ' G ouod PC� rower <br /> � � META L� ui� Air r ~ <br /> 830 MET�O�YL LARVAE <br /> TyI°E� AP�ID Sranules �ir Gra�ng <br /> PESTICIDES CONTINUED 3M eEXT PAGE ****** <br /> on-Ag Use: <br /> k -opditiops: Q,U,P ` Z <br /> f lia <br /> r� ntambil�t7 for any damag� <br /> uerstad � t this perit dces not relieve me rom I ive any <br /> persons or property caused by the use of these pe��ticides^ f A wa u�tore <br /> coape of liability for damages a�ainst thz Cnunty [)epartmentto t �r�c perm_t <br /> c� �m f �his �ermit I furt�er understand �a �n�= , <br /> based on t�e issuanco �� ` flict <br /> with <br /> evoked pe <br /> the manufacturer s <br /> uhen sticides are used in con <br /> mwmay e r ƒ }� able laws regulations a:d sPec c <br /> ��be�ing or in violatio» o aPP c � t ll reasona!�l� times a»d <br /> it I authrrize inspsction a a <br /> - conditions o� this Perm i ` ts by the Department c�ƒ pes��cide ��eg:lation or �he <br /> � w�enever an emergencY e: s ' ƒ ll aro�s treated or to b� treated , <br /> storage <br /> ��County �}epartme�t of Agriculture c z i t sed or- <br /> Branch], <br /> r to be used <br /> ti id r emptied containers and equ �ner u <br /> facilities for Pes c es o �7/g2) pest�c�de Enforcement 8ranc�] <br /> in the treatment . [Form 9R-ENF^125 (Rev, <br /> ww <br /> Sign . <br /> Permit /\ppt: <br /> | <br /> �� <br /> Date: <br /> Issuing officer: _�� <br />