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SAN JO.AQUIN WUN 1Y <br /> 2101 E F:ARHART-SUITE 100 2011 <br /> STOMON, CA 95206- <br /> Web:www.co.sn-joaquizLczi.us/agcm= <br /> l <br /> Office:(209)953-6000 Fax:(209 953-6022 Recorder(NCI's): (204)453-60D0 <br /> i <br /> ruw <br /> Pe 1iti'+itimhtW- 39-11 X1506 <br /> 70T.F7.7T M&.R <br /> 14807 F R W.F RUAT3 Comity District#: D <br /> ' <br /> T.1NfTF.I�F CA 9'�73fi- <br /> Expiration Date: December 31,2011 <br /> Effective Bate: Janus 1, <br /> I <br /> RT MART) 70T.F= Home Phone: (209) 931-0291 7i <br />! 1487 F- R iVITT:F.R OAT) shop Phone: ( s - <br /> �..' <br /> T.TNnPW. CA 917.16- Mobile Phone: 1 1 - <br /> Fax: 12091 911-91"11 <br /> i <br /> Pem3ittee Type: private Applicator NUI Mahed of Suhmixsiow <br /> Petwit Tvpe: gaaennal Phone: Y Fax: Y Box: <br /> Possession: Possession &Use IM Person: X Web:X Modem: ) <br /> N01 reauired 24 flours urior to aDi fication. <br /> See end ofp�zmit for <br /> Con&fi A,PU s s code de5fii 011s. <br /> -------------------------------- <br /> ------- <br /> I u nderstmd that this permit does not relieve me fi tan liability for any damages to any P��s�Proper wed --————- <br /> by the use of these pesticides. I waive any claims of liability fcr damages againa the County Depertmmt.of <br /> Agriculture bad an the ismiance of this permit I further understand that this peermit maybe revol¢ed when <br /> pesticides are used in conflict with the manufacturer's labeling or in violation of applicable laves,re�ul�itis and <br /> specific conditions of this permit. I authorise inspectim at all reasariable times and whenever an emergency exists <br /> by the Department of Pesticide Regulation or the Comity Departrient of Agriculture of all areas treated or to be <br /> avated,storage facilities for pesticides or emptied cotainers and equipment used or to be used in the treatmait. <br /> 3 I have considered alternatives and mitigation mea%res ptumat to Title 3,California Code of Regulatioxu,sectim 6426. <br /> Taking irla acccurit eccffiomic,EnVft-c:timeratal,social,and technological factors,I have adopted those that are feasible <br /> and w rind substantially lessen any significant adverse bnpact on the environment. <br /> [Form FR ENF-125 (Rev. 11/06)PesticideEnforcement,Branch i <br /> L y�� —� <br /> Permit Applicant Signed <br /> 1 (Please Print) <br /> Titte: f✓1 G-i1 Issue Date: <br /> k <br /> w ! Papa i <br />