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Restricted Materials Permit ,Conditions . . Page#: 1 of 3 <br /> .The_Following_Conditions, Apply",To -_ -_'_--__ <br /> ' Permit#: 39-02_3900062 <br /> ----------- <br /> WORMS SAMM SERIES'ATTACHED <br /> [X] A- 1 through -9-General Info` " , C_]- 3-1��Chol-inesterase Testing-_----- <br /> _ _ <br /> PE�2MIT. CONDITI'(�NSRATTACHED =__ _____ - _______-.-_= f <br /> :. <br /> � - --- --�- -.� <br /> ------------------------------ <br /> CX] P - General <br /> [X] Q - Dicamba & Phenoxy' Herbicides .. Central, V&11eyfHazardous .Area <br /> [_] R -- Dicamba .& Phenoxys.:- -Special Hatiardous rArea <br /> r C_] S -- Metam Sodium.& Metam Potassium <br /> [_] T - Aldica'rb (Temik).. F <br /> C �7 U - .Endosulfan (Thiodan) <br /> CT7 V - Rice Pesticides Program <br /> C_] Molinate (Qkdram) .Wo.rker Safety <br /> Attachments 1 9_ . .m6linate (1,6} thiobencarb (2;6,7) , .'carbofuran. <br /> .(3,6) , methylparathion . (4,'9.) and malathion (voluntary: 5.,8-) <br /> [X] -W Methyl Bromide <br /> [ ] Soil within greenhouses <br /> C�] Commodity . , <br /> [_] ':Soil injection <br /> C_] Tarped potting. soil <br /> C_] Single tree site. <br /> [� ] -X -- Furadan chemi'getion. of. grades <br /> CX]-Z Other.__=_:� __ -___ ___ <br /> -----____ - --- _ _ __ =-_-- <br /> y 'PESTICIDT SALES GR [JNDWATER: PROTTCTION� <br /> ,1 C-] The material ".I'.am- purchasing ;a 11Ll , of belused .in a Pesticide .Management <br /> Zone (as described in Section-:6Title 3, California..Code of Reg- <br /> ulations) . for agricultural-,..outdoor 'institutional. or, outdoor industrial. <br /> use. <br /> C_] The material I .am pu'rbh&6 ng ;gill "be used ir3 a Pesticide Management Zone <br /> (as described in,Seats vn,.,fi802 ;;`Tit3 a 3-s b aliforni:a Gude of Regulations) <br /> for agricultural, outdoor institutional or outdoor industrial use and a <br /> copy of, my,. restr: cted: materials permit is attadhed_. <br /> Material, .p. urchased: Atrazi,. n,fe -W . F <br /> Smazine ' Bromacil <br /> ] Dioun <br /> I Certify under penalty of..:pSPjury`'that the' °foregoing -Statement . is true, <br /> and that. I will 'n6t, appgly' any'-material. -1'.isted- in Section 6800(x) in any, <br /> Pesticide -Management Zone f6r,kagriculture, .'outdoor institutional or <br /> L outdoor industrial. uses except ,in -.accordance with. a permit issued 'by the <br /> county agricultural: cdinmi asioner. or the,,director.An A .county -in which <br /> there is, no commissioneir <br /> Purchas Date, <br /> x a <br /> �. . .,z . . .� <br />