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y.�'prF7 L'11F\� �T4t+ <br /> �i j 'p68 E. HA"("ELTON Av EN7JE' <br /> -. STOCKTON, CA 95205 Ak <br /> =fide; ( 209 )468-3300 Recorder (NOI ) ; ( 2139 )468-3300 FAX: ( 209 )468-3330 <br /> .ESTftiC'1'ED-MATERIALS�PERMIT P6rmit# : 39-02-3902102 <br /> County HQ Dist,:ictO ; ,3 <br /> 'COR.,. SURGIT Expi.ration. Date : 12/31/2002 <br /> X454 HANBURY WAY Effective Date. 02/21/2000 <br /> SACRAMENTO, CA 95829-6049 <br /> ;URGIT TOOR Home ; ( 916 )689-8667 <br /> i 2 7 W VERi3ALIS RD Shop; <br /> -.RACY, CA 95376 y Fax; <br /> Mobile ; ( 916 ) 342-07134 <br /> "ermittee Type=_=^Permit Type_ _-Possession No!WMethod-af�Submiss.ion r i <br /> -------------- , ----------T-- --------^=---- ----- ---------------- <br /> rivate App [hj Seasonal [Xa Poss L Use (XJ Phone [Xj Fax [ ] <br /> A Cert [ .lob [ J Poss Only [ j Bol; J iodE'Ii[ [ j <br /> -lig PCC) [ 1 iii Person [ J <br /> "von-Ag [ J NOI required 24 hours Prior to application <br /> - ____ <br /> vumb--Pesticide ----- Peat( s ) Form. Method' s ) A ppl�cator\ sJ <br /> ----- -----_----- ---- __ .-_----- --.___- <br /> 1051- SEVIN LARVAE Liquid Air Ground PCO Grower <br /> 13^00 CHLOROPICRIN 114 ATODE Fumigant Ground PCO Grower= <br /> 3 14 1 GUTHION MI TES All Reg riir Ground P CO Grower <br /> 3350 METHYL BROMIDE SOIL/STORED Fumigant Ground PCO Grower <br /> 0001 2 , 4-D AMINE WEEDS Lig,uid Ground PCO Grower <br /> 16011 PARAQUAT WEEDS Li_Lquid Air Ground PCO Grower <br /> 16891 SUPRACIDE LARVAE Liquid Air around PCO Grower <br /> Pon-Ag Use ; <br /> Conditions : PQW <br /> I understand that this permit-does^not relieve me from liability for any damage <br /> I 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 /> rased "on the issuance of this permit . I further understand that -this permit i <br /> may be revoked when pesticides are used in conflict with the manuf aCturer' S <br /> labeling or ii! violation of applicable laws , regulations and specific <br /> conditions of this permit . I authorize insi�ection 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 /> faciliti2::�, for pesticides or emptied containers and equipment used or t0 be used <br /> in the treatment. [norm PR-ENF-125 (Rev . 67,192 ) Pesticide Enforcement Branch] <br /> Permit Applicant: ff�I i-� -1zCr — Sign: ,--- <br /> Title : NU Date : <br /> Date: <br /> Issuing Officer: 3` Z7. �oc�ca <br /> i <br />