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SAN JOAQUIN COUNTY <br /> 1868 E. HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Office: (209)468-3300 Recorder (NOI ) : (209)468-3300 FAX : (209)468-3330 <br /> RESTRICTED MATERIAL'S' PERMIT <br /> County HO District*: H <br /> _ COLOMBINI FARMS Expiration Date: 12/31/2000 <br /> 4950 E MAIN ST Effective Date <br /> STOCKTON, CA 95205- <br /> JACK J COLOMBINI Home: (209)463-5180 <br /> 5395 N COX RD Shop: (209)466-9478 <br /> LINDEN, CA 95236- Fax : <br /> Mobile: ( )479-3691 <br /> -------------------------------------------------------------------------- <br /> Permittee Type Permit Type Possession NOI Method of Submission <br /> -------------- ------------ -------------- -------------------------- <br /> Private App [X] Seasonal [X] Foss & Use [X] Phone [X] Fax [X] <br /> O A Cert [ ] Job [ ] Pass Only [ ] Box [X] Modem C ] <br /> Ag FCD [ ] In Person [X] <br /> Non-Ag [ ] NOI required 24 hours prior to application <br /> ------------------------------------------------------------ <br /> Numb Pesticide Pest(s) Form. Methods) Applicator(s) <br /> _ ----- --------------- ------------ -------- ---------------- ------------ ---- <br /> 1051 SEVIN LARVAE Liquid Air Ground FCD Grower <br /> 1360 CHLOROPICRIN NEMATODE Fumigant Ground PCO Grower <br /> 2000 DICAMBA WEEDS Liquid Air Ground PCO Grower <br /> 2501 DI-SYSTON APHID Liquid Air Ground PCO Grower <br /> .=141 GUTHION MITES Liquid Air Ground PCO Grower <br /> 3850 METHYL BROMIDE SOIL/STORED Fumigant Ground PCO Grower <br /> 4840 ALUMINUM PHOSPH RODENTS Fumigant Ground PCO Grower <br /> 5540 STRYCHNINE GOPHERS Bait Ground PCO Grower <br /> 6260 ZINC PHOSPHIDE RODENTS Bait Air Ground PCO Grower <br /> 7860 MCPA, DIMETHYLA WEEDS Liquid Air Ground FCO Grower <br /> ****** PESTICIDES CONTINUED ON NEXT PAGE *#*#** <br /> Non-Ag Use: <br /> Conditions: POW JERRY MOBILE 471-6830 <br /> ------------------------------------------------------------------------- <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 <br /> ////PR--E;,N/F-`125/(Rev. 07/92) Pesticide -nforcement Branch] <br />_ <br /> Permit Applicant: �rWd C OCO, -►bc�,�" Sign. � <br />_ Title: �7Y7 _ JJ•• Date: <br /> Issuing Officer: 'f✓(L A�'P� /X X.l® Date: loL ` 1,3 — 9 g <br />