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D �?ATER-A1,S PERM I T con t i,nued . . . . . Page#: 3 <br /> FRESTRIC7E <br /> aILV;=; c SONS DAIRY. TCli;i�! r=-0 <br /> permits: �1- �904�01 <br /> ---WORKERS-SAFETY-ScPicS-ATTACHED_-' --- <br /> F----------------------- ------------------ <br /> CXJ A--'1 through A-9 General Infra. [_] B-i C'�ol nesLerase Testing <br /> rFF,'.•I_T C0 ND1 0 N S ATTACHE <br /> ------...__-----_____-_...---_..____.....____._._---_--..___----_- <br /> i [ ,. P - General 1 � <br /> 0 Di�c�-ii ba & Pher�t .;y i'ier -�icLdes Centrc.l 'v r.:J_ Iay1` azarCAous rrw <br /> [�f R - Dicamba & i:-h, noxys - Special xZ�r �,Cl: S fir" <br /> S — 3 letani a(Dd ll-Urr, f v?pail; ) <br /> C_1 T - Aldicarb (Temik <br /> �- 1 U - Endesulfan ( hioran )i <br /> F. C_ Molinato (Qrdrai } wo'leer <br /> 4w� Attachments 1-4 : 1Molinata ( 2.6,7 , ti i'GC)'Fur m <br /> �) 4 methylpar:.�ti`on ( 4 �9 ? and malathion ( volunta. ' : j,5) <br /> I - �l . <br /> Fw Methyl L7 rl�-fS;1.LIQ <br /> r ] Soil within greenErousss <br /> i <br /> [_'. Commodity <br /> F i i -oil my ection <br /> [4i Tarped 1_ _Li xQi- <br /> L_1 Single t:-ee site <br /> X � =uradan chi ligation, c. cJ�a es <br /> [X ] Z 3Cther <br /> FEW T ICI>3E SALES: GROUNDI.4ATE,R P007ECT Ii3N <br /> -----------------------------------------------"- ....._ ---_._. --_- <br /> 1F [ Tale material I an purcha sing will 1 1 not be used in a Pesticide Management <br /> i ___-_Zone-(as-described in Section 6807 Title 3 California Code of Reg- <br /> ulations) <br /> a b <br />€ ulations) fear agricultural , outdoor institut-1-oval or outdoor industrial <br /> use. <br /> [_] The material I am purchasing will be used in a Pesticide Management Zone <br /> ( as described in Section 6S?02, Title 3, California Code of Regulations ) <br /> for agricultural , outdoor institutional or outdoor industrial use and a <br /> F copy of my restricted materials permit is attached. <br /> FMaterial purchased : [_] Atrazine C_3 Simazine ,r_3 Bromacil <br /> C,_1 Diuron C_] Prometon [-I Ben tazon <br /> I Certify under penalty of perjury that the foregoing statement is true, <br /> and that I will not apply any material listed in Section 6800( a) in any <br /> P Pesticide Management Zone for agriculture, outdoor institutional or <br /> outdoor industrial uses except in accordance with a permit issued by the <br /> FL <br /> county agricultural commissioner or the director in a county in Which there is no commissioner. <br /> ----- ----- ---- <br /> urchaser Dace <br />