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SAN JOAQUIN COUNTY q�3 <br /> 1868 E . HAZELTON AVENUE /C <br /> STOCKTON, CA 95205 <br /> Web URL: www. co . san-joaquin . ca . us/agcomm <br /> E-Mail : <br /> Office : (209 ) 468-3300 Recorder (NOI ) : ( 209 ) 468-3300 FAX: ( 209 ) 468-3330 <br /> OPERATOR/SITE IDENTIFICATION NUMBER OPERATOR/SITE I.D. # 39-03-3908100 <br /> County HQ District # : C <br /> ROCHA, JOHN JR Expiration Date : 12/31/2003 <br /> 23733 E MARIPOSA Effective Date : _ ___ ___ 1990` <br /> ESCALON, CA 95320- `�-9 - 0,3 <br /> JOHN R.00HA Home : ( 209 ) 838-3464 <br /> j6 -9 - 03 <br /> 7 <br /> 23733 E MARIPOSA Shop : 2098386719 <br /> �. ESCALON, CA 95320- Fax: <br /> Mobile <br /> r <br /> Permittee Type Permit Type Possession NOI Method of Submission <br /> -------------- ------------ -------------- -------------------------- <br /> r. Private App I I Seasonal 1XI Poss & Use 1XI Phone I I Fax I ) <br /> Q A Cert I I Job I I Poss Only I I Bose I I Modem I ) <br /> Ag POO 1XI In Person I I Web ) ) <br /> Nan-Ag NOI required 24 hours prior to application <br /> Non-Ag Use : None <br /> Conditions : No Conditions <br /> . I understand that this permit does not relieve me from liability for any damage <br /> to persons 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 /> based on the issuance of this permit . I further understand that this permit <br /> ,may be revoked when pesticides are used in conflict with the manufacturer 's <br /> labeling or in violation of applicable laws, regulations and specific <br /> conditions of this permit . I authorize inspection at all reasonable times and <br /> whenever an emergency exists, by the Department of Pesticide Regulation or the <br /> ,County Department of Agriculture of all areas treated or to be treated , storage <br /> facilities for pesticides or emptied containers and equipment used or to be used <br /> in the treatment . [Form PR-ENF-125 (Rev. 07/92 ) Pesticide Enforcement Branch] <br /> `Permit Applicant �N//c �JS /tDG�JA Sign : <br /> Title : " o . eZ 4_k� Issue Date : <br /> ` Issuing Officer : Issue Dare : r� 'rc>3 <br /> Page 1 <br /> r <br /> r <br />