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SU0004637 SSCRPT
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SU0004637 SSCRPT
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Entry Properties
Last modified
5/7/2020 11:31:01 AM
Creation date
9/6/2019 10:25:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0004637
PE
2622
FACILITY_NAME
PA-0400301
STREET_NUMBER
23800
Direction
N
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
02105090
ENTERED_DATE
9/27/2004 12:00:00 AM
SITE_LOCATION
23800 N JACK TONE RD
RECEIVED_DATE
6/9/2004 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\J\JACK TONE\23800\PA-0400301\SU0004637\SSC RPT.PDF
Tags
EHD - Public
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SILVA W SONS O}.'","i IRI TONY ice'aI !IiUK : 29-00-39045C-, <br /> 700-390-Y' fes',,, <br /> WORKERS SAFETY HSERI=.:. ATTACHED <br /> -------------------------------- ---- ----------- ----------------- -------------- -- <br /> -_`._�]._y=.lthrol.1 C3,hMA=C?-Genera =_ ^ _o _ __-- I_===�_= -1 Cholinestarase Testing <br /> k <br /> .... - `..--i--CONDITIONS ATTACHED <br /> i,-,-l1-�„ <br /> EX] ;.J - wram.nera1. <br /> !_J 0 Dicamba L: Phanoxy Herbicides i.'fi'` Cantral 'i .1,ey/ :.s r„.I 1..1• wG; <br /> T r=;ld:4 ;arb (Temik <br /> . .] ,,J En osuif n (Thiodan) <br /> [J V _.. Rice Pesticides Program <br /> i (voluntary ; <br /> Attachments y1-9 : M lin _ ( 1 , 6) ��.!"'JC,�,,�rlE�-�irb ( ^ , 6 , 7, , ._,:,i".A"���'i!_lrs <br /> r (3 , 6) , .�IaL�11�lpar_i .�,Il4:SI (4 ,T) I�..I i la .�.'-.. I h ^Sos <br /> ma tI '1 s oitidI <br /> Soil within greenhousas <br /> rEJ1 ccf7lFlladit`a' <br /> EJ Soil injection <br /> [J Tarpad potting sci.l. <br /> E,1 Sinole tree site <br /> [.....] X - Fu r'c dan chemigation of w rapa:' <br /> PESTICIDE SALESi GROUNDWATER PROTECTION <br /> _ <br /> ---_--- __. ---..--•----- --.^_.__...._...._.______.._-w. -- -- <br /> ^_-.__�....__-__- --_---__._.._._........_.....r......_ ._.M. <br /> Ell' The materia� iiil Uf �1 sAiirvi inl111 it k �� Us.�C 1i� 5'LJ 1 w Management <br /> Zone (as described in Section 6002 , Title _ Cali"1ornl:a, Code of Reg- <br /> ulations.) for agricultural , outdoor institutional " or outdoor industrial <br /> use., <br /> CA The material I am purchasing will be used in a Pesticide Management Zone <br /> (c's G'esQribed in Section 0302 , Title Z, California, Code of Regulations) <br /> for agricultural , outdoor institutional or outdoor industrial' use and a <br /> copy of ill',;r r"5trict8d ma eri"I permit istta.ol ad. <br /> ilater ia,i purChcd;asd: {it;-.:7,:.ina i -,] Simazine I Fr'i'Gi aril <br /> Diu ton r_] Fro Ston CA s ntazon <br /> I Certify under penalty o perjury that the foregoing statement s i,i'uz, <br /> and that I will not apply any material listad' in Section 6200(x) in any <br /> eztinide Marlagemant Zona for agriculture , outdoor institutional or <br /> outdoor industrial uses axcept in accordance with :.t permit issued by 'Gilt~ <br /> county agricultural commissioner or the director in a county in which <br /> there is no C �i11i '.s 1uri:w7i" . <br /> 2 �___ <br /> P chaser Data <br />
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