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SAN JOAQUIN COUNTY <br /> 1868 E . HAZELTON AVENUE <br /> - STOCKTON, CA 95205 <br /> Web URL :www . co . san-joaquin . ca . us/agcomm <br /> E-Mail : <br /> Office : ( 209 ) 468-3300 Recorder (NOI ) : ( 209 ) 468-3300 FAX: ( 209 ) 468-3330 <br /> RESTRICTED MATERIALS PERMIT PERMIT It 39-03-3903043 <br /> County HQ District t! : C <br /> i <br /> BRUMLEY & SONS Expiration Date : 12/31/2003 <br /> 30500 E HWY 4 Effective Date <br /> FARMINGTON , CA 95230-9668 <br /> DON BRUMLEY Home : ( 209) 838-2135 <br /> 13381 ESCALON BELLOTA RD Shop : ( 209)838-2135 <br /> ESCALON, CA 95320- Fax: <br /> Mobile : ( 209) 479-0287 <br /> Permittee Type Permit Type Possession NOI Method of Submission <br /> -------------- ------------ -------------- -------------------------- <br /> ..2rivate App IXI Seasonal IXI Pose & Use IXI Phone IXI Fax IXI <br /> Q A Cert I I Job I I Pose Only I I Box IXI Modem I I <br /> Ag POO I I In Person IXI Web IXI <br /> Mon-Ag I I NOI required 24 hours prior to application <br /> Von-Ag Use : None <br /> ..,:onditions : PQV <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 /> ,used 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 oquipment used .or to be used <br /> in the treatment . [Form PR(-ENF-125 (Rev. 07/92 ) Pesticide Enforcement Branch] <br /> `Permit Applicant : �on1yJ ,kv"NIQI Sign : Z) 4"`Q � <br /> Title : '�NeC' Issue Date : a I ( 3 'X3 <br /> Issuing officer : Issue Date : � r / a — 03 <br /> Page 1 <br /> r <br />