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SAN JQAQU IN COUNTY <br /> 1806 8 E. HAZDEHLTONT AVENUE U 7 <br /> STOCKTON, CA 95245- <br /> �I x'21='uu.co.s�•j o aquin.ra.wlag�emtn <br /> Office: (209)468.3300 Fax (209)465.3330 Recorder(NCI']): (204 68-3300 <br /> F <br /> RESTRICTED MATERIALS PERMIT <br /> PIAN ELFT,FARES Permit Number: 39-07-3904556 <br /> 19919 VAN EEL RD Co DieLiet#: <br /> LO <br /> DI, CA 95242- Expiration Date: December 31, 2407 <br /> !. � Effective Date: january-t�: <br /> 10-667 <br /> �yy <br /> (_ORTdELIS P KOO ER Home Phone, <br /> t . <br /> 19919 VAN Al`d ESL R] Shop Phone: <br /> I <br /> LODI, CA 95242- Mobile Phone: <br /> �r Fix: i <br /> Pennittee 1�,pe: Psi'rate.Applicator NOI Method of Subm ssion- <br /> I <br /> Pennit'Type: Seasonal Phone: X Fax: X Pox: � <br /> Possession: Possession & Use In Person: X Modetu: Web: X <br /> NOI required 24 hours prior to application. <br /> F <br /> I <br /> F <br /> Conditions: A,P,Q <br /> r SPF cnd of penaAfor <br /> code descriptions. <br /> -- ------------------------------------ <br /> i r I understand that this permit does trot rel ieve me from liability for any damages to any persons o•property caused ——————— <br /> by the use of these pesticides. I waive any claims of liability for darnages against the County Department of <br /> Agriculture based of the issuance of this permit I fuurther understand that this pe<rmi may be revoked*Mien <br /> pesticides are used in conflict with the manufac ur el's labeling or in violation of spplicalale laws,regulations and <br /> specific widitions of this pen-nit. I authorize inLpectio-r at all reasonable times and whenever an Emerge-icy exists <br /> F by the Department of Pesticide Regulation or the County Department of Agriculture of all areas treated cc to be <br /> treated,stege facilities for pesticides or emptied oontaine-s and&4uiprneat used or to be used in the treatment. <br /> I have considered alternatives and mitigatieei measm es purmant to Title 3,California Code of Regulations,section 6426. <br /> F. Taking into account economic,environmental,social,and technological factors,I have adopted those that are feasible <br /> and would substantially lessen any significant adverse impact on the mvit miieit. ! <br /> [Form YR-ENF-125 (Rev, 11106)Pesticide <br /> + €esticideEnforcement Brnch <br /> Pen-nit Applicant ) <br /> Signed: <br /> (::;2= <br /> (Please Print <br /> yltie: d 4.0- <br /> Tissue Date: <br /> (PleAse Print <br /> F <br /> Issuing Officer: Issue Date: 1r <br /> 3 <br /> Fil <br />