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RESTRICTED MATERIALS PERMIT cont. Page 3 <br /> 6 MCCA-SLAND, MAUD Permit #: 39-99-3904833 <br /> ------------------------------------------------------------------------------- <br /> L --------------------- WORK:ERS SAFETY SERIES ATTACHED <br /> --- <br /> ------------------------------------------------ <br /> [X] A-1 through A-9 General Info. [_I B-1 Cholinesterase Testing <br /> - PERMIT CONDITIONS ATTACHED <br /> ------------------------------------------------------------------------------- <br /> [X] P - General <br /> [_] O - Dicamba &< Phenoxy Herbicides - Central Valley/Hazardous Area <br /> [_] R - Dicamba & Phenoxys - Special Hazardous Area <br /> L, [_] S Metam Sodium (Vapam) <br /> [_] T - Aldicarb (Temik ) <br /> C_] U - Endosulfan (Thiodan ) <br /> [_] V Rice Pesticides Program <br /> [_] Molinate (Ordram) Worker Safety <br /> [_] Attachments 1-9: Molinate ( 1 ,6) thiobencarb (2,6,7) , carbafuran <br /> L (3,6) , methylparathibn (4,9) and malathion (voluntary: 5,8) <br /> [X] W - Methyl Bromide <br /> [_] Soil within greenhouses <br /> [_] Commodity <br /> ` [_] Soil injection <br /> [_] Tarped potting soil <br /> [_] Single tree site <br /> ` [_] X - Furadan chemigation of grapes <br /> [_] Z - Other <br /> PESTICIDE SALES: GROUNDWATER PROTECTION <br /> ------------------------------------------------------------------------------ <br /> ` [ The material 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 /> 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 /> for agricultural , outdoor institutional or outdoor' industrial use and a <br /> ` copy of my restricted materials permit is attached . <br /> Material purchased : [_] Atrazine [-] Simazine [_] Bromacil <br /> L [_] Diuron C-] Prometon [_] Bentazon <br /> I Certify under penalty of perjury that the foregoing statement is true, <br /> and that L will not apply any material listed in Section 6800(a) in any <br /> 6. 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 /> L, there is no commissioner. <br /> 6. Purchaser <br /> Data <br /> v/ <br />