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SAN JOAQUIN COUNTY <br /> X1868 E. HAZELTON AVENUE -.or � v0� <br /> STOCKTON, CA 95205 <br /> Office : (209) 468-3300 Recorder (NOI ) : (209 )468-3300 FAX : (2G •3330 <br /> -------------- <br /> - RESTRICTED MATERIALS PERMIT Permit#: 39-01-3904309 <br /> County HO District#: E <br /> - LODI FARMING INC Expiration Date: 12/31/2001 <br /> 11292 N ALPINE RD Effective Date /2j2eb <br /> STOCKTON, CA 95212- 7 <br /> JEFF COLOMBINI Home: (209)334-3424 <br /> 11292 N ALPINE RD Shop: ( 209)948-4022 <br /> STOCKTON, CA 95212- Fax : <br /> Mobile: ( )369-5520 <br /> Permittee Type Permit Type Possession NOI Method of Submission <br /> -------------- ------------ -------------- -------------------------- <br /> Private App [X] Seasonal [X ] Poss & Use [ ] Phone [X] Fax [ ] <br /> O A Cert [ ] Job [ ] Poss Only [X] Box [X] Modem [ ] <br /> Ag PCO [ ] In Person CX] <br /> Nan-Ag [ ] NOI required 24 hours prior to application <br /> Numb Pesticide Pest( s) Form. Method ( s) Applicator(s) <br /> ----- --------------- ------------ -------- ---------------- ----------------- <br /> 1051 SEVIN LARVAE Liquid Air Ground PCO Grower <br /> 1061 FURADAN NEMATODE Liquid Ground PCO Grower <br /> 1360 CHLOROPICRIN NEMATODE Fumigant Fumigate PCO Grower <br /> 2001 BANVEL WEEDS Liquid Air Ground PCO Grower <br /> 2302 DISYSTON APHID Liquid Air Ground PCO Grower <br /> 2591 THIODAN LARVAE Liquid Ground PCO Grower <br /> 3141 GUTHION MITES Liquid Ground PCO Grower <br /> 3830 METHOMYL LARVAE Liquid Air Ground PCO Grower <br /> 3850 METHYL BROMIDE SOIL/STORED Fumigant Fumigate PCO Grower <br /> _ 4840 ALUMINUM PHOSPH RODENTS Other PCO Grower <br /> ****** PESTICIDES CONTINUED ON NEXT PAGE ****** <br /> Non-Ag Use.- <br /> Conditions: <br /> se:Conditions: PQWU 2 <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. GForm P EryF- 25 (Rev. 07/92) Pesticide Enforcement Branch] <br /> Permit Applicant: / Sign : yy <br /> _ Title : ��/�- Date: —J— ,9 Z _ <br /> y <br /> 3 <br /> Issuing Officer : Date: - O / <br />