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Restricted Materials Permit Conditions Page#: 1 of 3 <br /> E, Following Conditions Apply To . . . . . . . . . . . . . . . . .. . . . . Permit#: 39-02-3902017 <br /> --------- WORKERS-SAFETY-SERIES ATTACHED---------- - <br /> [X] A-1 through A-9 General Info. I [_J B-1 Cholinesterase Testing <br /> -- --- - ---- - - <br /> - ----- ------------------- -- ------- <br /> --- - - --------------PERMIT-CONDITIONS-ATTACHED--------_ <br /> - - - - ------------------ <br /> [XJ P - General <br /> [X3 0 - Dicamba & Pheroxy Herbicides - Ce&ral Valley/Hazardous Area <br /> L [_] R - Dicamba & Phenol-s - Special Hazardous Area <br /> [_] S - Metam SodiuIID & Metam Potassium <br /> T - Aldicarb (Tem ik) <br /> L [_] U - Endosulfan (Thiodan) <br /> [_J V - Rice Pesticides Program <br /> [_1 Molinate (Ordram) Worker Safety <br /> [_] Attachments 1-9: Molinate (1,6) tiiiobencarb (2,677), carbofuran <br /> (3,6) , methylparathion (4,9) and malathion (voluntary: 5,8) <br /> S9 - Methyl Bromide <br /> [_J Soil within greenhouses <br /> L [_] Commodity <br /> [_] Soil injection <br /> [_] Tarped potting soil <br /> [_J Single tree site <br /> L [_] X - Faradan c4qmigation of grapes <br /> [X] Z - Otrerviv�Gc e <br /> -------------------------- <br /> --------------------------------------- ------------------------ <br /> PESTICIDE SALES: GROUNDWATER PROTECTION <br /> L ----- - --------------------------------------------------------------- <br /> [ he-m-a-te--r-ial----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 /> [_J 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 /> L for agricultural, outdoor institutional or outdoor industrial use and a <br /> copy of my restricted materials permit is attached. <br /> Material purchased: [_J Atrazine [_] Simazine [_J Bromaoil <br /> [_I Diuron [_J Prometon [_] Bentazon <br /> I Certify under penalty of perjury that tae foregoing statement, is true, <br /> 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 /> ` <br /> she, ,..,.,.e '. 'n -0 issio er- <br /> Lchar r• Date <br /> L <br /> L <br />