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SAN JOAQUIN COUNTY <br /> 168 E. HAZELTON AVENUE 00 3 <br /> "STOCKTON, CA 95205 ../ <br /> Office: ( 209) 468-3300 Recorder (NOI ) : (209)468-3300 FAX : (209, 330 <br /> ----------------------------------------------------------------------------- <br /> ------------------------------------ <br /> .ESTRICTED MATERIALS PERMIT Permit#: 39-03-3400525 <br /> County HQ District#: E <br /> OTTA VINEYARDS, JOE A Expiration Date: 12/31/2003 <br /> 47414 KOST RD Effective Date rjs9/O/ <br /> GALT, CA 95632 / <br /> s0E A COTTA Home : (209)745-4538 <br /> 9414 KOST RD Shop: ( 209)745-4538 <br /> ALT, CA 95632 Fax : <br /> Mobile: (209)649-6911 <br /> Oermittee Type Permit Type Possession NOI Method of Submission <br /> ------------- ------------ -------------- -------------------------- <br /> Private App [ X] Seasonal [X] Pass & Use [X ] Phone [X ] Fax [ ] <br /> Q A Cert [ ] Job [ ] Pass Only [ ] Box [ ] Modem [ ] <br /> g PCO [ ] In Person [X] <br /> . on-Ag [ ] NOI required 24 hours prior to application <br /> ------------------------------- ----------------- ------ <br /> ------------------------------------ <br /> umb Pesticide Pest(s) Form. Method (s) Applicator(s ) <br /> ---- --------------- ------------ -------- ---------------- ----------------- <br /> T051 SEVIN LARVAE Liquid Ground PCO Grower <br /> 1061 FURADAN NEMATODE Liquid Ground PCO Grower <br /> 842 PHOSTOXIN RODENTS Fumigant Ground PCO Grower <br /> 56011 PARAQUAT WEEDS Liquid Ground PCO Grower <br /> Nan-Ag Use: <br /> onditions: PZ <br /> ------------------------------------------------------------------------- <br /> understand that this permit does not relieve me from liability for any damage <br /> .o 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 /> "ased on the issuance of this permit. I further understand that this permit <br /> ay be revoked when pesticides are used in conflict with the manufacturer' s <br /> Tabeling or in violation of applicable laws, regulations and specific <br /> conditions of this permit. I authorize inspection at all reasonable times and <br /> henever an emergency exists, by the Department of Pesticide Regulation or the <br /> wounty 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 used <br /> n the treatment . [Form PR-ENF-125 (Rev. 07/92) Pesticide Enforcement Branch] <br /> Permit Applicant: �)hi W Sign : ter /J C.7-KV <br /> Tit1e: �/'KSS. Date: /x <br /> Issuing Officer: Date: <br /> —T <br />