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SAN JOAQUIN COUNTY <br /> 1868 E. HAZELTON AVENUE D� <br /> STOCKTON, CA 95205 <br /> ..)ffice: (209 )46B-3300 Recorder ( NOI ) : (209)468-3300 FAX : ( 209) 468-3330 <br /> 9ESTRICTED MATERIALS PERMIT Permit#: 39-03-3904364 <br /> County HQ District#: G <br /> VM <br /> KLEIN RANCH OPER/THORNTON Expiration Date: 12/31/2003 <br /> O BOX 7424 Effective Date ,�/?�'A- <br /> *:TOCKTON, CA 95207- <br /> IUGENE CASALE Horne: ( 209)931-6337 <br /> O BOX 7424 Shop: (209)956-e8OO <br /> STOCKTON, CA 95207- Fax : <br /> Mobile: (209 )403-0002 <br /> 'Permittee Type Permit Type Possession NOI Method of Submission <br /> -------------- ------------ -------------- -------------------=------ <br /> rivate App [X] Seasonal CX ] Poss & Use [X] Phone [X] Fax [X] <br /> A Cert [ ] Job [ ] Poss Only [ ] Box [X] Modem [ ] <br /> Ag PCO [ ] In Person [X] <br /> "on-Ag [ ] NOI required 24 hours prior to application <br /> - ---------------- <br /> Numb Pesticide Pest(s) Form. Method (s) Applicator( s ) <br /> ----- --------------- ------------ -------- ---------------- ----------------- <br /> 050 CARBARYL LARVAE Liquid Air Ground PCO Grower <br /> 7141 GUTHION MITES Liquid Ground PCO Grower <br /> 3830 METHOMYL LARVAE Wettable Ground PCO Grower <br /> 840 ALUMINUM PHOSPH RODENTS Fumigant Ground PCO Grower <br /> .,_260 ZINC PHOSPHIDE RODENTS Bait Ground PCO Grower <br /> 9B01 2,4-D AMINE WEEDS Liquid Ground PCO Grower <br /> ' 6011 PARAQUAT WEEDS Liquid Ground PCO Grower <br /> "an-Ag Use: <br /> Conditions: PQZ <br /> I understand that this permit does not relieve me from liability for any damage <br /> '-o persons or property caused by the use of these pesticides. I waive any <br /> laim of liability for damages against the County Department of Agriculture <br /> Lased on the issuance of this permit. I further understand that this permit <br /> may be revoked when pesticides are used in conflict with the manufacturer ' s <br /> abeling or in violation of applicable laws, regulations and specific <br /> ..onditions of this permit. I authorize inspection at all reasonable times and <br /> whenever an emergency exists, by the Department of Pesticide Regulation or the <br /> ounty Department of Agriculture of all areas treated or to be treated , storage <br /> `acilities for pesticides or emptied containers and equipment used or toe used <br /> in the treatment. [Form PR-ENF-1 (Rev. 07/92) Pesticide En r-cement nch] <br /> l <br /> ermit Applicant: Sign : <br /> Title: F /}' �A'� 4 Date: / <br /> ••Issuing Officer: Date : / �/ Cj <br />