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SAN TOAQU iN COUNTY <br /> 1868 E. HAZELTON AVENUE <br /> STOCKTON, CA 95205- <br /> 1�-itlall: Web:i�`.ni�iv.co.san-)oaquin.ca.nsE2Dco*men <br /> Office: (204)458.3300 Fax: (204)468-3330 E.e`-ordiet`(:�T0I'sj: (309)469-=300 <br /> REESTIJCTED :vLALTERI-XLS PERMIT <br /> GOLDEN�INC erm it Num der -19-04-3900187- <br /> 11981 S ROBERTS RD County District z: I <br /> S TOC'K i ON, CA 95206- Expiration hate: Dece-m ber .3 1, 0Q4 <br /> Effective Date: Januar-; 1,49994- <br /> L/, <br /> ,-1 - <br /> L f, <br /> ARV-rN EO-ST—ER 4L)J6 CRome Phone- (2091462-4738 <br /> SliguIPL (2-091462-307-5 <br /> STOCKTON. CA 95206- Mobile P110nC..: � o - <br /> Fax: <br /> Permittee TVP e: Private . pplizator NOI Method of Submission: _ <br /> Permit 'I�;-:Pe: Season tj;!!ie: `' 3 ax: X ISd : <br /> Possession: Possession Only In Person: ' Modem: adv'& <br /> NOI required 24 J-hou s Prior to amlicati_orl. <br /> Conditions: A P,Q,T See end of permit for <br /> code deserption5, <br /> --------------------- ------------------------- <br /> I understand that this Perfekt does not relieve me frcrn liability fes=any damage.-to;sly p -:s cc pr�Tpe<-ty 1-13'ed <br /> by t11e uw of thea p sticid s. I waive any claims cf liability for dafxnages against the County Department of <br /> Ag-icultl.u-e based xi the issuance of this pe` -lit_ I further understand that this permit may be revoked when <br /> pes-ticides are used in conflict with file manufacturer's labeling or in eiolatic-i of applicable laws,regulatims and <br /> specific c-znditic�is of this z1Erfnit ±auillofize inspection at 11_reasoriabi_e tirnes and a;hunevt an emErgst <br /> ency ex <br /> by the Department.of Pesticide Regllatien or the Camty Depafsne_nt of Agriculture of all areas treated or to be <br /> treated,xUrage facilities for pEssti,cides or e_rfiptied cu-itainErs and c-uipflet'!t uged car to be L,-%d if the ti 2 cleft <br /> [Form PI'-EI-IF-1-"5 (Re%T. Pe icidde Enfct-cement l ig-anch] <br /> � <br /> Pit � <br /> � z <br /> _�r�I.liic�ot: : i�'t?ed: <br /> '(Please Prints <br /> ts f°3 ?~c �`�`T i`1 �ssue Date- <br /> -ii L <br /> (Please Print) I <br /> Issuing Officer �V4• .?i �L• f A' Tssule i`ste: Z 4 <br />