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Restricted Materials PeriMt Conditions Page#: 1 of 3 <br /> The Following Conditions Apply To . . . . . . . . . . . . . . . . . . . . . . Permit#: 39-05-3900341 <br /> WORKERS SAFETY SERIES ATTACHED <br /> [X] A-1 through A-9 General Info. [_] 8--1 Cholinesterase Testing <br /> PERMIT CONDITIONS ATTACHED <br /> ------------------- <br /> [X] P - General <br /> [X] Q - Dicamba & Pheroxy Herbicides -- Central Valley/Hazardous Area <br /> [_] R Dicarrzba & Pheno.,;ys -- Special. Hazardous Area <br /> [_] S Metam Sodium & Metarn Potassium <br /> T - Aldicarb (Temik) <br /> [_] U - Endosulfan (Thiodan ) <br /> [_] V - Rice Pesticides Program ' <br /> [_] Molinate (Ordr. am) Worker Safety <br /> Attachments 1 --9: Molinate " 1 ,6' thiobencarb (2, 6,+') , �_�arbofuran <br /> (3,6) , methylparathion (4,9) and malathion (voluntary: 5,8) <br /> [X] W Methyl Bromide <br /> _ [_] Soil within gr eenhou;seo <br /> [_] Commodity <br /> [_] Soil injection <br /> [_] Tarped potting soil <br /> [ �<_ Single tree site <br /> [_] X Furadan chemlgation of grapes <br /> [_] Z - Other <br /> -------------------------------------------------------------------------------- <br /> PESTICIDE SALES: GROUNDWATER PROTECTION <br /> The material I am purchasing will ret be used in a PesticideManagement <br /> Zone (as described in Section 6802, Title 3, California Code of Reg- <br /> ulations) for agricultural, outdoor institutional or outdoor industrial <br /> use. <br /> [_] The material I am purchasing will be used in a Pesticide Management Zone <br /> (as described in Section 6802, Title 3, California Code of Regulations) <br /> for agricultural. , outdoor institutional or outdoor industrial use and a <br /> copy of my restricted materials permit is attached. <br /> Mater--al purchased: [_] Atrazine [_] Simaz,ine [_1 Bromacil <br /> [_] Diuron [_] Prometon [_] Bentazon <br /> i Certlfy under penalty of perjury that the foregoing statement is true, <br /> and that I will not apply any material. listed in Section 6300(a) in any <br /> Pesticide Management Zone for agriculture, outdoor instit.ational or <br /> outdoor industrial uses except i i accordance with a. permit iseued by the <br /> c-unty a ,ultural commissioner or the director in a County it e:h ic"r, <br /> L re i u 1,commi sinner. <br /> /- zy-o3 <br /> P urchas.e r <br />