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WORK SITE PLAIN <br /> Methyl Bromide FAME7.777-U IINFORItiLkTION <br /> - Commodity Fumigarion <br /> Description This `,Vcr.'t Site Plan has Jive sections: <br /> Section A records general information about tLe wort site. <br /> Section 3 records compliance with general permit conditions. <br /> Section C is used to de,.--:.rine the size of the buffer zones. <br /> Section D records cornriiance with other srecinc conditions. <br /> — Section 3 records =orma*.ion for alternate conditions. <br /> Instructions The Work Site Plan m=' L be completed and submitted to the <br /> County A=icuitural Commissioner. The dors Site Pian is <br /> considered complete wl:e-- all the auestionss is the appropriate <br /> _ sections are answered. :��er the comule:ed Work Site Plan is <br /> evaluated by the Agr.'c•_,',:,nal Commissicne-, Renu cted renals <br /> Permits must be issued to both the facility operator and pest <br /> .. control business, if applicable. <br /> U - 2QOa A Restricted Materials Permit cannot be issued unless <br /> all questions in the appropriate sections are <br /> -� ��,; y��, i;�^,� ,y answered. Incorrect information on the Work Site <br /> _ Plan will result in denial of the permit. <br /> Fu rigaticn Site: DELTA PACKING CO. , .OF LODI INC. <br /> Address: 5950 E.• KETTLEMAN LANE -City: LODI Zip: 952W <br /> Contact Person: Phone: <br /> (Fae:Iiry Operator,Grower,QAC Liccwce,etc) <br /> Pest Control Business: Permit Number. . <br /> Address: Cary: P <br /> Contact Pe-sow•� Phone: <br /> T-=MCy op"Mm Gtb-w,QAC.Lksm=eco.) _ -- <br /> z <br /> VF--.4=. THAT TIM-FOLLO lC INFO1..MAnoN 7s:ACCURATE <br /> BEST OF IMY KNOWLEDGE...• <br /> S i atuze- / Date•. . �l /' D <br /> Sn <br /> - . Title: / <br /> 8./&/94 �; <br />