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SU0004813 SSCRPT
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SU0004813 SSCRPT
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Last modified
5/7/2020 11:31:14 AM
Creation date
9/9/2019 11:00:47 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0004813
PE
2622
FACILITY_NAME
PA-0500017
STREET_NUMBER
715
Direction
S
STREET_NAME
WAGNER
STREET_TYPE
RD
City
STOCKTON
APN
15907016
ENTERED_DATE
2/8/2005 12:00:00 AM
SITE_LOCATION
715 S WAGNER RD
RECEIVED_DATE
2/1/2005 12:00:00 AM
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\W\WAGNER\715\PA-0500017\SU0004813\SSC RPT.PDF
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EHD - Public
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SAN JOAQUIN COUNTY ,20OD <br /> 1868 E. HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Office: (209 )468-3300 Recorder (NOI ) : (209)468-3300 FAX : (209 )468-3330 <br /> L RESTRICTED MATERIALS PERMIT Permit# 39-00-3904309 <br /> County HQ District#: E <br /> LODI FARMING INC Expiration Date: 12/31/2000 <br /> 11292 N ALPINE RD Effective Date <br /> STOCKTON, CA 95212- <br /> L JEFF COLOMBINI Home: (209)334-3424 <br /> 11292 N ALPINE RD Shop: (209)948-4022 <br /> STOCKTON , CA 95212- Fax: <br /> L ----------------------------------------------------------Mobile--(---)369_5520 <br /> ------------------------------------------------------------------------------- <br /> Permittee Type Permit-Type- Possession---- NOI Method of Submission <br /> ------------- ---------- -------------------------- <br /> Private App [X] Seasonal [X] Poss & Use [ ] Phone [X] Fax [ ] <br /> Q A Cert [ ] Job [ 7 Poss Only [X] Box [X] Modem [ ] <br /> LAg PCO ( ] In Person '(X] <br /> Non-Ag C ] 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 /> L1360 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 /> L2591 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 /> L 34X1 FENXCAP LARYAE LWid GpOur(d PCO Grower <br /> ****** PESTICIDES CONTINUED ON NEXT PAGE <br /> Non-Ag Use: <br /> LConditions: PQWU <br /> I understand that this permit does not relieve me from liability for any damage <br /> Lto 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 /> 6. 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-ENF-125 (Rev . 07/92 ) Pesticidenfot�rnat r n h] <br /> Permit Applicant: ' t (.UrD^"4�r Sign: 11 <br /> 1/10 <br /> Title: P S4 /'".' - <br /> Issuing Officer : Date: <br />
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