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SAN JOAQUIN COUASTy � n^�-- <br /> 15 Ei3 E . HAZELTO N AVENUE <br /> STCCKTON, Cd^i 95205 <br /> � L+TeL lJRS. :F14TYe" . CG . Sari-'i Gacj F}i n . CB . usfagcr,rflrn <br /> E-mail <br /> office : ( 209) 468-3300 Recorder (1401 ) : ( 209 ) 46.3-3300 FAX: ( 209j468-3320 <br /> -------------- <br /> RESTRI'TED h°ATER.IALS PERMIT PERMIT A : 39-03-3903330 <br /> LCounty HQ, District 9 : C <br /> ROCHA, SC}H!•F SR DAIRY Expiration Date : 12/31/2002 <br /> 23733 MARIP-ISA RD Effective Date 05/31:�'20Q'4'. <br /> ESCALON. t:.A 95320 <br /> 6. <br /> J0__ff4 R.00TiA Home : 2098353464 <br /> 23733 MARIPOSA. RD sznop: 2093386715" <br /> ESCJALON, CA 95320 Fax: <br /> Mobile <br /> Permittee Type Permit Type Possassion 1.101 Method of Submission <br /> --------------- ------------- -------------- --------------------------- <br /> b-Private App 1 _{I Seasonal {X! Pols: & Use 1X1 phone IXI Fax 1XI <br /> Q A Cart I I .lob I I Poss only 1 1 Box IX; Modem I I <br /> Ag PCO I I In Person JXJ Web II"i <br /> Dion-Ag 1 1 -I40I required 24 hours prior to app)icatior, <br /> Non-Ag Use : None <br /> LU�ndition= : PQ2 <br /> �I ur;d6rstand that this-permit doe�� not relieve }ne from liebility-for any damage <br /> to persona or property caused by the use of these pesticides . I waive any <br /> claim of liability for damages against the County Department of Agriculture <br /> baser] on the issuance of this permit . I further understand that this permit <br /> lrmay be revoked when pesticides are used in conflict with the manufacturer 's <br /> labelincd or in violation of applicable laws, regulations and specific- <br /> conditions <br /> pecificconditions of this permit . I authorize inspection at all reasonable times and <br /> whenever an emerciancy exists by the Department of Pesticide Regulation or the <br /> 6.C.ounty Department of Agriculture of all areas treated or to be treated, storage <br /> faci?ities: fir pesticides -ar. emptied containers and ecluipFnent used or e uva:: <br /> in the treatment . rForm PR-ENF-125 (Rei.- . 071)92 ) Pesticide Enforc en t rich) <br /> dlPermit Applicant : � Al <br /> Title: Issue <br /> Issuing Officer : - ? 'sue Data : <br /> V <br /> V <br /> Y <br /> 6 <br />