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SAN JOAQUIN COUNTY <br /> *.,,,1868 E_ HAZELTON AVENU] <br /> STOCKTON, CA 95205 <br /> Office: (209)468-3300 Recorder (NOI): (209)468-3300 F/- (209)468-3330 <br /> -RESTRICTED MATERIALS PERMIT Permit#: 39-01-3901041 <br /> County HQ District#: B <br /> _BOURBEAU, J PAUL Expiration Date: 12/31/2001 <br /> 18401 S WAGNER Effective Date : 012001 <br /> RIPON, CA 95366- 0Z <br /> -PAUL J BOURBEAU Home: (209)599-4508 <br /> 18401 S WAGNER Shop: (209)599-4508 <br /> RIPON, CA 95366- Fax: <br /> Mobile: ( } - <br /> ------------------------------------------------------------------------------- <br /> ------------------------------------------------------------------------------- <br /> Permittee Type Permit Type Possession NOI Method of Submission <br /> -------------- ------------ -------------- -------------------------- <br /> Private App [X] Seasonal CX) Poss & Use [X] Phone CX] Fax 1X1 <br /> Q A Cert [ Job C 1 Poss Only C I Box [XI Modem C I <br /> Ag PCO C ] In Person CX] <br /> -Non-Ag [ NOI required 24 hours prior to application <br /> ------------------------------------------------------------------------------- <br /> ------------------------------------------------------------------------------- <br /> Numb Pesticide Pest(s) Form. Method(s) Applicator(s) <br /> ----- --------------- ------------ -------- ---------------- ----------------- <br /> 1041 CAPTAN DUST FUNGI Dust Air Ground PCO Grower <br /> 1051 SEVIN LARVAE Wettable Air Ground PCO Grower <br /> 1360 CHLOROPICRIN NEMATODE Fumigant Fumigate PCO Grower <br /> -2000. DICAMBA WEEDS Liquid Ground PCO Grower <br /> 2301 DI-SYSTON LARVAE All Reg Air Ground PCO Grower <br /> 2590 ENDOSULFAN LARVAE Wettable Ground PCO Grower <br /> -3830 METHOMYL LARVAE All Reg Ground PCO Grower <br /> 3850 METHYL BROMIDE SOIL/STORED Fumigant Fumigate PCO Grower <br /> 4782 THIMET LARVAE All Reg Air Ground PCO Grower <br /> -4840 ALUMINUM PHOSPH RODENTS Fumigant Fumigate PCO Grower <br /> ****** PESTICIDES CONTINUED ON NEXT PAGE *** ** <br /> Non-Ag Use: <br /> Conditions: PQUWZ <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 /> —may 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 /> Permit Applicant: ���h J. &&/Z/3—AV Sign: <br /> Title: C/"` f72T Date: (�n <br /> Issuing Officer: ������ Y- 000ate: Z <br />