Laserfiche WebLink
RESTRICTED MATERIALS PERMIT continued . . . . . Page# : 4 <br /> 46ELLA VISTA FARMS Permitn : 39-00-3902017 <br /> ---------------- ----------------------------------------------------- <br /> WORKERS SAFETY SERIES ATTACHED <br /> r------------------------------------------------------------------------------- <br /> [,i] A-1 through A-9 General Info . ' <br /> _� B-1 Cholinesterase Testing <br /> ---------------------------------------------- <br /> ------------------------------------------------------------------------------- <br /> PERMIT CONDITIONS ATTACHED <br /> ---------e---------------------------------------------- <br /> -------------------- <br /> [X] P - General <br /> [X] Q - Dicamba & Phenoxy Herbicides - Central Valley/Hazardous Area <br /> (_] R - Dicamba & Phenoxys - Special Hazardous Area <br /> L S - Metam Sodium (Vapam) <br /> (_] T - Aldicarb (Ter„ik) <br /> [_] ti - Endosuifan (Thiodan) <br /> [_] V - Rice Pesticides Program <br /> [_] Molinate (Ordram) Worker Safety <br /> [_] Attachments 1-9 : Molinate . ( 1 , 6 ) thlobencarb ( 2 , 6 , 7 ) , carbofuran <br /> L <br /> ( 3 , 6 ) , methylparathion (4 , 9 ) and malathion (voluntary: 5 , 8 ) <br /> I� [_] W - Methyl Bromide <br /> [_J Soil within greenhouses <br /> [_] Commodity <br /> (_] Soil injection <br /> [_] Tarped potting soil <br /> [_] Single tree site <br /> (_] X - Furadan chemigation of grapes <br /> [_] Z - Other <br /> ----- -- ----------- <br /> ----------PESTICIDE-SALES_- -GROUNDWATER-PROTECTION <br /> [ The material I am purchasing will not be used in a Pesticide Management <br /> Zone (as described in Section 6802 , Title 3 , California Code of Reg- <br /> ulations ) for agricultural , outdoor institutional or outdoor industrial <br /> use . <br /> [_] The material I am purchasing will be used in a Pesticide Management Zone <br /> (as described in Section 6802 , Title 3 , California Code of Regulations) <br /> for agricultural, outdoor institutional or outdoor industrial use and a <br /> L copy of my restricted materials permit is attached. <br /> Material purchased : [_] Atrazine [_] Simazine [_] Bromacil <br /> [_] Diuron (_] Prometon (_] Bentazon <br /> I Certify under penalty of perjury that the foregoing statement is true, <br /> L and that I will not apply any material listed in Section 6800( a) in any <br /> Pesticide Management Zone for agriculture , outdoor institutional or <br /> outdoor industrial uses except in accordance with a permit issued by the <br /> county agricultural commissioner or the director in a county in which <br /> 6. the e ' s 4uha <br /> c issioner . <br /> --tl - --------- -- - --`- -- <br /> 6' e Date <br /> L <br /> L <br />