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SAN JOAQUIN COUNTY <br /> 1868 E. HAZELTON AVENUE <br /> 6. STOCKTON, CA 95205 <br /> Office: (209) 468-3300 Recorder (NOI ) : (209)468-3300 FAX : (209 <br /> LRESTRICTED MATERIALS PERMIT PERMIT/OPERATOR I .D. #: 39-99-190483= <br /> County HQ District #: F <br /> MCCASLAND, MAUD Expiration Date: 12/31/2001 <br /> L 11345 E JAHANT RD Issue Date: j/j �/yr�tr <br /> ACAMPO, CA 95220- <br /> LMAUD MCCASL.AND Home: (209)368-3067 <br /> 11351 E JAHANT RD Shop: (209)368-3067 <br /> ACAMPO, CA 95220- Mobile: <br /> L - FOR RESTRICTED MATERIALS PERMIT USE-ONLY - - <br /> Permit Type: Poss. Only C ] Seasonal [X] Pass. €< Use [X] Job C ] <br /> Permittee Type: Q.A. Cert [ ] Ag . PCO [ ] Private App [X] Non-Ag [ ] <br /> LNOI required 24 hours prior to application . <br /> Method : Rhone [X] Box [X] Person [X] Modem C 7 Fax [X] <br /> L Numb -Pesticide------ Pest(s) <br /> ----- Form_-- - Method (s)------- Applicator(s)---- <br /> 1360 CHLOROPICRIN Nematode Fumigant Ground PCO Grower <br /> L3850 METHYL BROMIDE Soil/Stored Fumigant Ground PCO Grower <br /> 5540 STRYCHNINE Gophers Bait Ground FCO Grower <br /> 16011 PARAOUAT Weeds Liquid Ground PCO Grower <br /> Non-Ag Use: <br /> L Conditions: PW <br /> ------------ <br /> I understand that this permit does-not relieve me from liability-for any damage <br /> to persons or property caused by the use of these pesticides. I waive any <br /> claim of liability for damages against the County Department of Agriculture <br /> Lbased on the issuance of this permit. I. further understand that this permit <br /> may be revoked when pesticides are used in conflict with the manufacturer' s <br /> labeling or in violation of applicable laws , regulations and specific <br /> conditions of this permit. . I authorize inspection at all reasonable times and <br /> whenever an emergency exists, by the Department of Pesticide Regulation or the <br /> County Department of Agriculture of all. areas treated or to be treated , storage <br /> facilities for pesticides or emptied containers and equipment used or to be <br /> used in the treatment. [Form 33-125/v3 .53 (Rev. 02/16/90) Pesticide Enforcement <br /> Branch] <br /> Permit Applicant. ) Sign : <br /> L Title: -'7 4P Date- <br /> Date <br /> ate: <br /> Date <br /> issuing Officer: ^� <br /> I <br /> r <br />