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PoulN SAN JOAQUIN COUNTY AGRICULTURAL COMMISSIONERS OFFICE 2012 <br /> ''•,o <br /> 2101 E EARHART AVE, SUITE 100 <br /> STOCKTON, CA 95206 <br /> Office: (209) 953-6000 Fax: (209) 953-6022 <br /> c✓ P••- Email: stocktonag2@sjgov.org Web: a"•+ .m.san-joaquin.ca.us/agoomm <br /> O <br /> r• <br /> RESTRICTED MATERIALS PERMIT: 39-12-3904762 <br /> Operator: PIRES,ANTONIO #3904762-2012-Version: 1 <br /> 23800 JACK TONE RD. County District#: F <br /> ACAMPO, CA 95220 Issued on: A1//'711,7— <br /> Vali d <br /> /ZValid as of 7 v <br /> Attention: ANTONIO PIRES Expires on: 1 / 1/ 2 <br /> OIG, AL Home Phone: <br /> Office Phone: <br /> Mobile Phone: <br /> Fax: <br /> Type of Use: Agricultural Use <br /> Notices Of Intent required 24 hours <br /> Pesticide Possession and Use prior to application of pesticide <br /> Possession: containing restricted materials <br /> Permit Duration: Seasonal <br /> Conditions: A, P, Q See condition detail <br /> for code descriptions. <br /> Regulatory Notes: <br /> --------------------------------------------------------------------------------------------------------------------------------------- <br /> 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 /> r on the issuance of this permit. I further understand that this permit may be revoked when pesticides are used in conflict <br /> with the manufacturers 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: <br /> (Name 8 Title) <br /> Applicant Signature: Date: 7—1 zj <br /> 7� U <br /> Issuing Officer: -- Date: / / <br /> i <br /> r <br /> Page 1 <br />