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SAN JOAQUIN COUNTY AGRICULTURAL COMMISSIONERS OFFICE <br /> 2101 E EARHART AVE, SUITE 100 <br /> U': STOCKTON, CA 95206 <br /> ? Office: (209)953-6000 Fax: (209)953-6022 <br /> CgCr�oR �P Email: stocktonag2@sjgov.org Web: www•co.san-joaquin.ca.us/agcomm <br /> RESTRICTED MATERIALS PERMIT: 39-14-3900040 ORIGINAL <br /> Operator: BLOSSOM FARMS #3900040-2014-Version: 1 <br /> P 0 BOX 799 County District#: H J. . <br /> LINDEN, CA 95236 Issued on: i- <br /> C.. <br /> Valid as of: /–C)<--/,C//,C/J• <br /> Agent: RAJKOVICH,RANDALL Expires on: 12/31/2014 <br /> Primary Phone: <br /> Alternate Phone: <br /> Mobile Phone: <br /> Fax: <br /> Type of Use: Agricultural Use Notices Of Intent required 24 hours <br /> Pesticide Possession: Possession and Use prior to application of pesticide <br /> Permit Duration: Seasonal containing restricted materials <br /> Employees Handle Pesticides <br /> Permit Conditions: A,P,Q,0,W.B See condition detail for <br /> code descriptions. <br /> Regulatory Notes: <br /> --------------------------------------------------------------------------------------------------------------------------------------- <br /> understand that this permit does not relieve me from liability for any damages to any persons or property caused by the <br /> use of these pesticides. I waive any claims of liability for damages against the County Department of Agriculture based <br /> on the issuance of this permit. I further understand that this permit may be revoked when pesticides are used in conflict <br /> with the manufacturer's labeling or in violation of applicable laws, regulations, and specific conditions of this permit. <br /> authorize inspection at all reasonable times and whenever an emergency exists by the Department of Pesticide <br /> Regulation or the County Department of Agriculture of all areas treated or to be treated, storage facilities for pesticides or <br /> emptied containers and equipment used or to be used in the treatment. I have considered alternative and mitigation <br /> measures pursuant to Title 3, California Code of Regulations, section 6426. Taking into account economic, <br /> environmental,social,and technological factors, I have adopted those that are feasible and would substantially lessen <br /> any significant adverse impact on the environment. <br /> [Form PR-ENF-125(Rev 11/ sticide Enforc ent anch] <br /> –4 Applicant: ,y7 VIC1 �,o <br /> (�1 e&Titl <br /> Applicant Signature: Date: — <br /> Issuing <br /> ate: —Issuing Officer:C d if� LC CFL' Date: <br /> Page 1 <br />