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... '`/ ,Z O o O <br /> SAN JOAQUIN COUNTY <br /> 1868 E . HAZELTON AVENUE <br /> _ STOCKTON, CA 95205 <br /> Office : ( 209 )468-3300 Recorder (NOI ) : ( 209 )468-3300 FAX : ( 209 )468-3330 <br /> RESTRICTED MATERIALS PERMIT Permit# : 39-00-390412-3 <br /> County HQ District# : <br /> DELTA PACKING Expiration Date : 12/31/2000 <br /> X950 E KETTLEMAN LN Effective Date ;z/ <br /> LODI , CA 95240- <br /> .EEMAN METTLER Home : ( 209 )334-1023 <br /> 5950 E KETTLEMAN LN Shop : ( } <br /> '-ODI , CA 95240- Fax : <br /> Mobile : ( ) <br /> Permittee Type Permit Type Possession NOI Method of submission <br /> -------=------ ------------ -------------- -------------------------- <br /> -Private App [ ] Seasonal [X] Poss & Use [X] Phone [X] Fax [ <br /> Q A Cert [ ] Job [ ] Poss Only [ l Box [ ] Modem <br /> 4g PCO [ ] In Person [X] <br /> Von-Ag [X] NOI reu red 24 hours prior t_- applicat' on <br /> Numb Pesticide Rest(s) Form. Method(s) App' ica:or(s) <br /> ----- --------------- ------------ -------- ---------------- ----------------- <br /> -1051 SEVIN LARVAE Liquid Air Ground PCO Grower <br /> 3141 GUTHION MITES Liquid Air Ground PCO Grower <br /> 3850 METHYL BROMIDE SOIL/STORED Fumigant Fumigate PCO <br /> .5540 STRYCHNINE GOPHERS Bait Ground PCO Grower <br /> 16011 PARAQUAT WEEDS Liquid Ground PCO Grower <br /> Non-Ag Use: <br /> ^.onditions : PW <br /> -------------------------------------------------------------- <br /> I understand that this permit does not relieve me from liability for any damage <br /> to persons or property caused by the use of these pesticides. ' I waive any <br /> -claim of liability for damages against the County Department of Agriculture <br /> based on the issuance of this permit. I further understand that this permit <br /> •nay be revoked when pesticides are used in conflict with the manufacturer's <br /> _labeling or in violation of applicable laws , regulations and specific <br /> conditions 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 /> County Department of Agriculture of all areas treated or to be treated, storage <br /> -facilities for pesticides or emptied containers and equipment used or to be used <br /> in the treatment. [Form PR-ENF-125 (Rev . 07/92 ) Pesticide Enforcement Branch] <br /> -P e r m i t Applicant: l- �' .� ,^ 3�" `� �` 't-� Sign : <br /> Title: ozz"Lz) Date: <br /> Issuing Officer: Date: <br />