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SAN JOAQUIN COUIGI'Y <br /> 1868 E. HAZELTON AVENUE <br /> STOCKTON, CA 95205- * <br /> E-mail: Web:u+cvw.co.sap-joaquin.ca.usfagcomm <br /> _ <br /> Office: (209)468.3300 Fax: (209)468.3330 Recorder(NOI's): (209)468.3300 <br /> RESTRICTED MATERULS PEIMHT <br /> ROCHA JR,JOHN Penrit Number: 39-04-3903039 <br /> 23733 E MARIPOSA County Disttict#: C <br /> ESCALON, CA 95320- Ripiration Date: December 31, 2004 <br /> Effective.Date: , <br /> 6-Z-7-0y <br /> JOHN ROC'HA Hoose Phone: (209)838-3464 <br /> 23733 E MkRIPOSA Shop Phone: (209) 838-6719 <br /> ESCALON, CA 95320 Mobile Phone: ( ) - <br /> F-tic <br /> Permittee Type: Private Applicator- N01 Method of Submission- <br /> - PemttType: Seasonal Phone: X Fax: X Box X <br /> Possession: Possession&Use In Person: X Modem: Web: x <br /> _ NOI required 24 hours prior to almlication <br /> Conditione_: AX,Q See end of pemtit fir <br /> code descriptions, <br /> I understand that this permit does not relieve me from liability for any damages to any persons or property caused <br /> by he use of these pesticides. I waive any claims of liability for damages against the County Department of <br /> 4triculbare based ent the issuaiue of flus penmtit. I finther understand that this permit nosy be revoked,when <br /> pesticides are used in co±iftiet with the manufacturer's labeling or in violation of applicable laws,regulations and <br /> specific conditions of this permit I wathorize inspection at all reasonable times and whenever m emergency exists <br /> by the Department of Pesticide Regulatimi or the Courity Depar<mcnit of 44,•icuiture of all areas treated or to be <br /> treated,storage facilities for pesticides or•emptied axitainers and equipment used or to be used in the tre-aument. <br /> — tForm PR-ENF-l25 (Rev. 07192)Pesticide Enforcetment Branch} <br /> 5 � / <br /> ner,F" App'Jcata ���` �� ✓f 1C 5 <br /> Signed:- <br /> (Please <br /> igned:(Please Pnrd) <br /> Title: _ Issue Dater <br /> (Prase is t) // <br /> r /y a� SLI <br /> — T=ytraiR.o Officer: - y <br /> rciee Date. <br />