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L %4/ SAN JOAQUIN COUNTY <br /> 1868 E. HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> 7ffice: (209)468-33.00 Recorder (NOI) : (209)468-3300 FAX:. (209)468-3330 <br /> RESTRICTED MATERIALS PERMIT Permit#: 39-00-3904227 <br /> County HQ District#: G <br /> HIGHWAY 12 FARMS ''' Expiration Date: 12/31/2000 <br /> � 0 BOX 4101 Effective Date <br /> >TOCKTON , CA 95204- <br /> MICHAEL SCRIVEN Home: (209)477-1107 <br /> O BOX 4101 Shop: (209)368-5220 <br /> -STOCKTON, CA 95204- Fax: <br /> Mobile: (209)483-5885 <br /> ----------- <br /> ---------- ----------ermittee Type Permit Type Possession NOI Method of Submission <br /> -------------- ------------ ------- ---- ------------------------- <br /> "�rivate App [X] Seasonal [X] Poss & Use [X] Phone [X] Fax [ ] <br /> I A Cert [ ] Job [ ] Poss Only [ ] Box [X] Modem [ ] <br /> -Ag PCO [ ] In Person [X] <br /> Non-Ag [ ] NOI required 24 hours prior to application <br /> -Numb Pesticide Pest(s) Form. Method(s) Applicator(s) <br /> ----- --------------- ------------ -------- ---------------- ----------------- <br /> 101 AMINO TRIAZOLE WEEDS Liquid Ground PCO Grower <br /> 6.050 CARBARYL Liquid Air Ground PCO Grower <br /> 2000 DICAMBA WEEDS Liquid Air Ground PCO Grower <br /> -302 DISYSTON APHID Liquid Air Ground PCO Grower <br /> ;824 METASYSTOX-R APHID Liquid Air Ground PCO Grower <br /> `3830 METHOMYL LARVAE liquid Air Ground PCO Grower <br /> 3940 METHYL PARATHIO LARVAE Liquid Ground PCO Grower <br /> 782 THIMET APHID Granules Air Ground PCO Grower <br /> "661 SYSTOX LARVAE Liquid Air Ground PCO Grower <br /> 5750 ALDICARB NEMATODE Granules Ground PCO Grower <br /> **W** PESTICIDES CONTINUED ON NEXT PAGE ****** <br /> V,on-Ag Use: <br /> Conditions: PQRT <br /> -- - - <br /> 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 /> laim of liability for damages against the County Department of Agriculture <br /> used 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 /> county Department of Agriculture of all areas treated or to be trea d, storage <br /> acilities for pesticides or emptied containers and equipment used r o be used <br /> �n the treatment, [Form PR-ENF-125 (Rev. 07/92) Pesticide Enfo ceme r nch] <br /> Lermit Applicant: � -1(CH m 12Q�Rwrj-� Sign: <br /> Title: Date: <br /> LIssuing Officer: Date: <br /> L <br />