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SAN JOAQUIN COUNTY _ <br /> L 1868 E. HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Web URL : www. co . san-joaquin . ca . us/agcomm - - <br /> E-Mail : <br /> L Office : ( 209 ) 468-3300 Recorder (NOI ) : (209 ) 468-3300 FAX: ( 209 ) 468-3330 <br /> i <br /> RESTRICTED MATERIALS PERMIT PERMIT t7 :_ 39-03-3903187 <br /> ►. <br /> CountyHQDistrict # : C <br /> GREEN FARMS - Expiration Date : 12/3IZ2003 <br /> j� 30'324 E LONE TREE RS] Effective, Date : C**_-. 845 . <br /> OAKDALE . CA 95361- <br /> RICK <br /> 5361-RICK GREEN Home: ( 209 )848-0401 <br /> 30324 E LONE TREE RD Shop: ( 209 )848-0401 <br /> OAKDALE, CA 95341- Fax: <br /> Mobile . ( 209)985-?930 <br /> LPermittee Type Permit Type Possession NOI Method of :Submission <br /> -------------- ----------- -------------- -------------------------- <br /> Private App (X( Seasonal (XJ Pose E. Use {Xi Phone (X( Fax {X( <br /> LQ A Cert { ( Sob ( Pose Only ( ! Box (Xl Modem I ( <br /> Ag PCO ( ( In Person (X( web (X) <br /> Dion-Ag ( ( NOI required 24 hours prior to application <br /> Non-Ag Use : None <br /> Conditions , PQV <br /> r <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 /> 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 /> 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 b used <br /> L" in the treatment . (Form PR-ENF-125 (Rev . 07%92 ) Pesticide it rcement Br c } <br /> r <br /> LPermit Applicant : _ �VePy Sign <br /> Title: /�F', h� 1- _ Issue Date : �-_e7 <br /> Issuing Officer �/v OW`Zt -�a�r� .._ _ Issue Date . 2-If <br /> t Fat1e 1 <br /> I <br /> L <br /> L <br /> 1 <br /> L <br />