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2002 <br /> SAN JOAQUIN COUb= <br /> a.. 1868 E. HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Web URL :www. co .san-joaquin . ca .us/agcomm <br /> E-Mail <br /> Office : (209 ) 468-3300 Recorder (NOI ) : (.209)468-3300 FAX: ( 209) 468---3330 <br /> RESTRICTED MATERIALS PERMIT —PERMIT # W39-02-3900062- <br /> County HQ District #: D <br />_ CAFFESE, EUGENE Expiration Date: 12/31/2002 . <br /> 5475 VAN ALLEN RD Effective Date : 0 <br /> STOCKTON', CA 95205- VgJ� a � <br /> EUGENE CAFFESE Nome: (209 )463--8067 <br /> 5475 VAN ALLEN RD Shop : (209)463--9406 <br /> STOCKTON. CA 95205- Fax: <br /> Mobile <br /> Permittee Type Permit Type Possession Nal Method of Submission <br /> -------------------------- <br /> Private APP Ix1 Seasonal IXI Pass & Use IXI Phone <br /> IXIFax <br /> II <br /> Q A Cert I Jab I I Pass. Only I I Box 1XI Modem I I <br /> y Ag FCU I I In Person IXI Web I I <br /> Non-Ag I I NOI required 24 hours prior to application <br /> Non-Ag Use : None <br /> Conditions : PQWZ QAL 38150 <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-ENE-1.25 (Rev. 07/92) Pesticide Enforcement Branch] <br /> Permit Applicant: �? L .5 Sign : r��e�� <br /> Title : Issue Date: <br /> Issuing Officer : Issue Date : /-/--o Z., <br /> 10 Page 1 <br />