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r <br /> _ SAN JOAQUIN COUNTY <br /> 1868 E . HAZELTON AVENUE �D.Z <br /> STOCtCTON, CA 95205 <br /> r web URL :'Www. co . san-joaqu.in . ca .us/agr_prnm <br /> E-Mail . <br /> Office : ( 209 )4613-3300 Recorder (NOI ) : ( 209) 468-3300 FAX: ( 209 )468-3330 <br /> RESTRICTED MATERIALS PERMIT PERMIT # : 39-02-3903093 <br /> County Fitt District # : C <br /> r <br /> BRUMLEY & SONS Expiration Date' 1213112040 <br /> 30500 E HWY 4 Effective Date O1 <br /> r FARMINGTON, CA 95230-9668 <br /> DON BWLRU T.Ey Home: ( 209)838-2135 <br /> 13381 ESCALON BELLOTA RD Shop: ( 209 )838-21:35 <br /> ESCALON, CA 95320- Fax: <br /> Mobile : ( 209)479-0267 <br /> r <br /> Permittee Type Permit. Type Possession NOI Method of Submission <br /> -------------- ------------ -------------- -------------------------- <br /> "' Private App ]XI Seasonal IXI Poss & Use IXI Phone IXI Fax IXI <br /> p A Cert I I sob I I Poss only I I Box IXI Modem I I <br /> Ag POO I I In Person IXI Web IXI <br /> ` Non-Ag I 1 140I required 24 hours prior to applicatic <br /> Non-Ag Use: None <br /> Conditions : PQVZ <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 Countv Department of Agriculture <br /> r based 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 /> Ir 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 w3e <br /> in the treatment . [Form PR-ENF-125 (Rev. 07/92 ) Pesticide Enforcement Branch) <br /> v <br /> Permit Applicant : ��Ne,A ��`aam�N� Sign : <br /> r Title: 04ri-er Issue Date: -j fol <br /> Issuing Officer : Ei� Issue Date: <br /> 6. Page 1 <br /> i <br /> r <br />