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' o� ytk e SAN JOAQUIN COUNTY AGRICULTURAL COMMISSIONERS OFFICE <br /> 2101 E EARHART AVE, SUITE 100 <br /> zka�r x�,y <br /> w t r STOCKTON, CA 95206 <br /> ' Office: (209) 953-6000 Fax: (209)953-6022 <br /> tld y r P Email: stocktonag2@sjgov.org Web: � co.sen-joaquinxams/agwmm <br /> ' RESTRICTED MATERIALS PERMIT: 39-13-3904239 <br /> Operator: KOOYMAN,MICHAEL #3904239-2013-Version: 1 <br /> 22666 N. MAY RD. County District#: F <br /> ' ACAMPO, CA 95220 Issued on: /// / <br /> Valid as op// g ty <br /> Agent: MIKE KOOYMAN Expires on: 12/3{/2013 <br /> Primary Phone: <br /> (� <br /> Alternate Phone: <br /> OinUGINAIa Mobile Phone: <br /> Fax: <br /> Type of Use: Agricultural Use <br /> ' Pesticide Possession: Notices Of Intent required hours <br /> Possession and Use prior to application of pesticide <br /> Permit Duration: Seasonal containing restricted materials <br /> ' Permit Conditions: A, P, Q See condition detail for <br /> code descriptions. <br /> Site Conditions: B,GWP-R3 <br /> ' Regulatory Notes: <br /> --------------------------- --------------------------------------------------------------------------- ------------------------------- <br /> ' I understand that this permit does not relieve me from liability for any damages to any persons or property caused by the <br /> use of these pesticides. I waive any claims of liability for damages against the County Department of Agriculture based <br /> on the issuance of this permit. I further understand that this permit may be revoked when pesticides are used in conflict <br /> ' with the manufacturer's labeling or in violation of applicable laws, regulations, and specific conditions of this permit. I <br /> authorize inspection at all reasonable times and whenever an emergency exists by the Department of Pesticide <br /> Regulation or the County Department of Agriculture of all areas treated or to be treated, storage facilities for pesticides or <br /> emptied containers and equipment used or to be used in the treatment, i have considered alternative and mitigation <br /> ' measures pursuant to Title 3,California Code of Regulations, section 6426. Taking into account economic, <br /> environmental, social, and technological factors, I have adopted those that are feasible and would substantially lessen <br /> any significant adverse impact on the environment. <br /> ' [Form PR-ENF-125(Rev 11/06) Pesticide Enforcement Branch] <br /> Applicant: �A t bW; <br /> eme 8 Title) <br /> ' Applicant Sig ure: <br /> ' Issuing Officer: Date: <br /> Page 1 <br />