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SAN JOAQUIN COUNTY <br /> ZaQ <br /> 1868 E. HAZELTON A `` <br /> STOCKTON, CA 95205- <br /> E-mail: Web:wwrv.co.san-joaqumca.udagcomm <br /> Office: (209)468.3300 Fax: (209)168.3330 Recorder(NOI's): (209)468.3300 <br /> RESTRICTED MATERIALS PERMIT <br /> GREEN FARM. Permit Number: 39-04-3903187 <br /> 30324 E LONE TREE RD <br /> County District iP: C <br /> OAK-DALE, CA 95361- Expiration Date: December 31, 2004 <br /> Effective Date: icy <br /> RICK GTdTN Home Phone: (209)848-0401 <br /> 30324E LONE TREE RD Shop Phone: (209) 847-1238 <br /> OAKDALE, CA 95361- Mobile Phone: (209)985-3930 <br /> Fax <br /> IVI <br /> Permittee Type: Private Applicator ?dui"eulod o;Suburissiora: <br /> Permit Type: Seasonal Phone: X Fax: X Box X <br /> Possession: Possession&Use In Person: X Modem: Web: X <br /> NOi required 24 'hours prior to application. <br /> Conditions: A,P,Q,RICE See end of permit for <br /> code descriptions. <br /> — — — — — — — — — — — — — — — — — — — — — — — — — — — — — <br /> I understand that this perrait does not relieve the from liability for any damages to why persons or property caused <br /> by the use of these pesticides. I waive any claims of liability for damages against the County Department of <br /> A4 icultn•e based on the issuance of this pennit I further understand that this permit maybe revoked when <br /> pesticides are used in conflict with the ntanufactn-er's labeling or in violation of applicable laws,regulations and <br /> specific conditions of this petinit I autliorize inspection at all reasonable times and whenever an emergency exists <br /> by the Department of Pesticide Regulation or the Conray Department of Apiculture of all areas treated or to be <br /> treated,storage facilities for pesticides or emptied containers and eauivinent used or to be used in the treatment. <br /> IFonnl PR-ENF-125 (Rev. 07192)Pesticide Enforcement Branch 1 <br /> Pem- aAwlicmit ah �- 1�7ree 8irste� e ���' ✓ <br /> ' (PIL2SE Print <br /> Tide: d- Gs ^�z e t- Issue Date: `/ — t; <br /> _ (Please Print <br /> Issuing 0flicer: - Issue Date: - — � <br />