Laserfiche WebLink
1 <br /> Restricted Materials Permit Conditions Page#: 1 of 4 <br /> The Following Conditions Apply To . . . . . . . . . . . . . . . . . . . . . . Permit#: 30--02-3900351 <br /> WORKERS SAFETY SERIES ATTACHED <br /> ------------------------------------------------------------------------------- <br /> G CX1 A--i through A-9 General Info. 1 C_] B-1 Cholinesterase Testing <br /> PERMIT CONDITIONS ATTACHED <br /> [X] P -- General <br /> [X] Q - Dicamba & Phenoxy Herbicides - Central Valley/Hazardous Area <br /> R - Dicamba & Phenoxys - Special Hazardous area <br /> [_] S - Metam Sodium & Metam Potassiu�i <br /> [_] T - Aldic:arb (Temik) <br /> [X] U - Endosulfan (Thiodan) <br /> C C_] V - Rice Pesticides Program <br />€ C_.7 Molinate (Ordram) Worker Safety <br /> C_ ] Attachments 1-9: Mo linate ON)) thiobenc arb (2.6.7 ) . car•bofuran <br /> (3,6) , methyl,para.thion (4,9) and malathion (voluntary: 5,8 ) <br /> CX] W - Methyl Bromide. <br /> [_] Soil within greenhouses <br /> [_] Commodity <br /> [_1 Soil injection <br /> [_,,,] Tarped potting soil <br /> [_] Single tree site <br /> [_] X - Furadan chemigation of grapes <br /> [X] Z - Other <br /> - -------- --------PESTICIDE SALES: GROUNDWATER PROTECTION <br /> -[-]- l - - - <br /> The material Iam purchasing will not be used inaPesticide Management <br /> Zone (as described in Section 6802, Title 3, California Cade of Reg- <br /> ulations) for agricultural, outdoor institutional or outdoor industrial <br />�. <br /> use. <br /> k [_] 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 /> Material purchased: 1_1 Atrazine [_ Simazine [_] B-roiacil <br /> [_ Diuron C_1 Proyeton [_] Bentazon <br /> I Certify under penalty of perjury .that the foregoing statement is true, <br /> and that I will not apply any material listed in Section 6800(a) in any <br /> Pesticide Management Zone for agriculture, outdoor institutional or <br /> outdoor industrial uses except in accordance with a permit issued by the <br /> county agricultural commissioner or the director in a county in which <br /> there is no commissioner. <br /> Purchaser Date <br />