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Page 4 <br /> SAN JOAQUIN COUNTY <br /> 1868 E. HA2ELTON AVENUE <br /> STOCKTON, CA 95205- <br /> E-mail: -reb:www.co.san-joaquimea uslagcomm <br /> Office: (209>468.3300 Fax: (209)468.3330 Recorder(DIOPs): (209)468.3300 <br /> RESTRICTED MATERLALS PBRIt1TP <br /> DELUCCBL MICHAEL Permit Number: 39-04-3900115 <br /> 2795 S HOLLENBECK RD County District#: D <br /> STOCK-TON, CA 95205- Faq*aflon Date: December 31, 2004 <br /> Effective Date: January 1,4"0- <br /> W- CHAEL DELUCCHI Home Phone: (20914 98+1 <br /> 2795 S HOLLENBECK RD Shop Phone: ( ) - <br /> STOCKTON, CA 95205- Mobile Phone: 7`—6P3;33 <br /> Fax: <br /> Permittee Type: Private Applicator NOI Method of Subm;<sion <br /> Pernrit Type: Seasonal . Phone: X Farr Box: X <br /> Possession: Possession &Use In Person: X Modem: Web: <br /> NOI required 24 hours prior to application. <br /> Conditions: A P,Q,U See end of permit for <br /> code descriptions. <br /> — — — — — — — — — — — — — — — — — — — — — — — — — — — — — <br /> I understand that this permit does not relieve me from liability for any damages to any persons or property caused <br /> _ by the use of these pesticides. I waive any claims of liability for damages against the County Department of <br /> Agriculture based on the issuance of this permit I further understand that this permit may be revoked when <br /> pesticides are used in conflict with the manufacturer's labeling or in violation of applicable laws,regulations and <br /> specific conditions of this permit I authorize inspection at all reasonable times and whenever an emergency exists <br /> by the Department of Pesticide Regulation or the County Department of P.gricuittne of all areas treated or to be <br /> treated,storage facilities for pesticides or emptied containers and equipment used or to be used in the treatment <br /> [Form PR-ENF-125 (Rev. 07192)Pesticide Enforcement Branch] <br /> ` P � o Signed: <br /> Permit Appficanfi� <br /> (Please Amt <br /> Title: Issue Date: �— <br /> (Please t) <br /> Issuing Officer. Issue Date: <br />