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— SAN JCA UNCCUNrof <br /> 1868 E. HAZELTON AVENUE i ��- <br /> STOC_T70N, CA 95205- <br /> E-mail: :Web:c w.ao.san-ionquin.ca.u:Jageoimn <br /> Office:(209)448.3300 Fax: (209)468.3330 Recorder(NOI's): (309)463-3300 <br /> OPERATOR IDENTIFICATION NII11'ISER <br /> ROCHA JR, JOIPV 4nerator Identification#: 39-04-3903100 <br /> 23733 E MARIPOSA Cot-ndy District C <br /> ESCALON, CA 95320- Extviration Date: December 31, 2004 <br /> Effective Date: i4 17, 2004 <br /> JOHN ROCHA Home Phone: (209)838--3464 <br /> 23733 E M-�LRIP03A Shop Phone, (209) 838-6719 <br /> E5C'ALON, CA 95320- Mobile Phone: ( ) <br /> Fa_s <br /> Permittee Type: Non-Certified <br /> Conditions: <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 pe ticides. I waive any claims of liability for damages against the County Department of <br /> AViculture based on the issuance of this permit I fiarther understand that this permit may be revolted when <br /> pesticides are used in conflict with the rnanafacturer's labeling or in violation of applicable laws,ten cations and <br /> epecific conditions of this permit I authorize inspection at all reasonable times and whenever an emergency exists <br /> by the Departrnent of Pesticide Regulation or the County Department of Agriculture 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 FR-EeT-123 (Rev. 67:92)Pesticide Enforcernent Bi mrh j <br /> Perna t Applicant To v4J /C(�a Q �k Signed, <br /> [p ease p.^at - <br /> n <br /> Tide: tel[ Issue Date: <br /> Issiiing.0111 r: f xl Issue pate: <br />