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SAN JOAQUIN COUNTY <br /> 1868 E . HAZELTON AVE . <br /> STOCKTON , CA 95205 <br /> Office : ( 209 )468-3300 Recorder ( NOI ) ( ) - FAX : ( 209 )468-3330 <br /> RESTRICTED MATERIALS PERMIT PERMIT/OPERA"TOR Z .R. r : 39-94-"3903298 <br /> Count- HQ District = : C <br /> CENTENO, HECTOR Expiration Date : 12/31/94 <br /> 15997 SEXTON Issue Date : <br /> " ESCALON, CA 95320- <br /> HECTOR CENTENO Home : ( 209 )838-1434 <br /> 15997 SEXTON Shop: ( ) - <br /> ESCALON, CA 95320- Mobile : ( 209 )471-0435 <br /> FOR RESTRICTED MATERIALS PERMIT USE ONLY <br /> Permit Type: Poss. Only ; ; Seasonal ;X; Poss. & Use ;X ; Job <br /> Permittee Type : Q.A. Cert . ; ; Ag. PCO ; Private App ;X; Non-Ag <br /> AOI required 24 hours prior to application. <br /> lethod: phone ;X ; box ;h; person ;X; modem fax ;X <br /> Numb Pesticide Pest ( s ) Form. Method( s ) Applicator( s ) <br /> ----- --------------- ------------ -------- ---------------- --------------- <br /> 1051 SEVIN Larvae Liquid Air Ground PCO Grower <br /> 1061 FURADAN trematode Liquid Air Ground PCO Grower <br /> 3830 METHOMYL Larvae Liquid Air Ground PCO Grower <br /> 7860 MCPA, DIMETHYLA Weeds Liquid Air Ground PCO Grower <br /> 3801 2 ,4-D AMI XE Weeds Liquid Ground PCO Grower <br /> 16011 PARAQUAT Weeds Liquid Air Ground PCO Grower <br /> ?0080 PERMETHRIN Larvae Liquid Air Ground PCO Grower <br /> 11630 BROMOXYNIL BUTY Weeds Liquid Ground PCO Grower <br /> 22941 ASANA Larvae Liquid Air Ground PCO Grower <br /> Non-Ag Use: <br /> Conditions: PQ <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 /> -laim of liability for damages against the County Department of Agriculture <br /> -)ased 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 /> :onditions 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 /> :acilities for pesticides or emptied containers and equipment used or to be <br /> used in the treatment. [Form 33-125/x3 . 53 ( Rev. 02/16/90 ) Pe ti ide Enfor eme <br /> T3ranch] �1 <br /> 'ermit Applicant: &4V r- C4,(, P-wD Sign: <br /> Title : Date : /� _Iry <br /> Issuing Off icer• r Date : <br />