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SAN JOAQUIN COUNTY <br /> F ("1868 E. HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Office : ( 2Q9 )468-3300 Recorder (NOI ) ( 209 )468-3300 FAX: ( 209 )468-3330 <br /> F-IRESTRICTED MATERIALS PERMIT PERMIT/OPERATOR I .D. # : 39-96-3901284 <br /> County HQ District' # : A <br /> PHILLIPS, RICHARD Expiration Date : 12/31/96 <br /> k 12277 S UNION RD Issue Date : (—r- q , <br /> MANTECA, CA 95336- <br /> RICHARD PHILLIPS Home : ( 209 )858-2696 <br /> 12277 S UNION RD Shop: ( 209 )858-2696 <br /> MANTECA, CA 95336- Mobile : <br /> FOR-RESTRICTED <br /> -=----------- -_--_==---T------___,__--__---__ <br /> MATERIALS PERMIT USE ONLY <br /> FPermit Type : Poss . Only ; ; Seasonal ; X ; Poss . & Use ;X; Job <br /> Permittee Type : Q.A. Cert ; ; Ag . PCO Private A ' g ' <br /> prior to application. <br /> NOI required 24 hours PP , X . Non-A= , <br /> Method: phone ;X ; box ; X ; person ;X ; modem ; X; fax 'X <br /> F-',, <br /> _ <br /> Numb Pesticide Pest( s ) Form. Method( s ) Applicator( s ) <br /> _ _ <br /> ----- ---------------- ------------ -------- ----------------- ----------------- <br /> F1051 SEVIN Larvae Liquid Ground PCO Grower <br /> 1360 CHLOROPICRIN Nematode Fumigant Fumigate PCO Grower <br /> 1980 DIAZINON Larvae All Reg Ground PGO Grower <br /> 3850 METHYL BROMIDE Soil/Stored Fumigant Fumigate PCO Grower <br /> 4840 ALUMINUM PHOSPH Rodents Fumigant Fumigate PCO Grower <br /> 5540 STRYCHNINE Gophers Bait Ground PCO Grower <br /> 16011 PARAQUAT Weeds Liquid Ground PCO Grower <br /> X16891 SUPRACIDE Larvae Liquid Ground PCO Grower <br /> _i 20080 PERMETHRIN Larvae Liquid Ground PCO Grower <br /> 22941 ASANA Larvae Liquid Ground PCO Grower <br /> Fjj 99901. ENVY 2 , 4-D AMIN Weeds Liquid Ground PCO Grower <br /> PNon-Ag Use : <br /> Conditions : PQW <br /> M <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 /> F' 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 /> Fconditions 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 /> rCounty 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 <br /> used in the treatment [Form 3 - 5/v3 . 53 {Rev . 02/16/90esticid nforcement <br /> Branch] <br /> Permit Applicant : 1e-j� Yl� M� , Sign: ri <br /> Title . ;� _(j ,a.c�L Date . _ /c�� :�� �l•j <br /> Issuing Officer: / e <br /> � � ' Date : _ �`Z <br />