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SAN JOAQUIN COUNTY <br /> 1868 E. HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> .ffice: (209)468-3300 Recorder '(NOI ) : (209)468-3300 FAX: (209)468-3330 <br /> RESTRICTED MATERIALS PERMIT Permit#: 39-00-3900196 <br /> County HQ District#: D <br /> MICHELOTTI FARMS INC Expiration Date: 12/31/2000 <br /> 13 BARRINGHAN LN Effective Date : 01/05/2000 <br /> ..ODESTO, CA 95350- <br /> - ICK <br /> 5350-- ICK MICHELOTTI Home: (209)527-1483 <br /> 5 LADD ROAD Shop: (209)529-6299 <br /> MODESTO, CA 95356- Fax: I <br /> Mobile: (209) <br /> ------------------------------------------------------------------ <br /> 1'ermittee Type Permit Type Possession NOI Method of Submission <br /> -------------- ------------ -------------- -------------------------- <br /> rivate App [X] Seasonal [X] Foss & Use [X] Phone CX] Fax [X] <br /> ,. A Cert [X] Job C I Foss Only [ ] Box CX] Modem [X] <br /> Ag PCC [ ] In Person [X] <br /> .'on-Ag C ] NOI required 24 hours prior to application <br /> IQumb Pesticide - ---Pest(s)------Form. - Method (s)--------Applicator(s) <br /> -'--- ---------------- ------------ -------- ---------- <br /> 01 AMINO TRIAZOLE WEEDS Liquid Ground FCO Grower <br /> -e051 SEVIN LARVAE Liquid Air Ground PCO Grower <br /> 1061 FURADAN NEMATODE Granules Air Ground PCO Grower <br /> 000 DICAMBA WEEDS Liquid Air Ground PCO Grower <br /> „301 DI-SYSTON APHID Liquid Air Ground PCO Grower <br /> 3824 METASYSTOX-R APHID Liquid Air Ground PCO Grower <br /> 7.830 METHOMYL LARVAE Wettable Air Ground PCO Grower <br /> 782 THIMET APHID Granules Air Ground FCD Grower <br /> 840 ALUMINUM PHOSPH RODENTS Fumigant Ground PCO Grower <br /> 5751 TEMIK NEMATODE Granules Ground PCO Grower <br /> i***** PESTICIDES CONTINUED ON NEXT PAGE <br /> Jan-Ag Use: <br /> Conditions: Q,P QAC 13255 <br /> Z 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 /> :laim 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 /> abeling or in violation of applicable laws, regulations and specific <br /> �orrditions 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 /> "oun ty Department of Agriculture of all areas treated or to be treated , storage <br /> 'acilities for pesticides or emptied containers and equipment used or to be used <br /> n the treatment. '[Form PR-ENF-125) ((Rev. 07/92) Pesticide E orcement Branch] . <br /> 'ermit Applicant: �L)- ��' I & Sign : ` <br /> u <br /> Title: The AA. A�" Date: <br /> , Issuing Officer: __ Date: _ �� <br />