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SAN JOAQUIN COUNT: 1 1868 E. HAZELTON AVENUE `, STOCKTON, CA 95205 Office: (209 )468-3300 Recorder (NOI ) : ( 209 )468-3300 FAX: ( 209 )468-3330 RESTRICTED MATERIALS PERMIT PERMIT/OPERATOR I . D. 39-99-3902007 County HQ District J A...,AL`D0, B & B Expiration Date: z1-3/- 5 16505 TRACY BLVD Issue Date: TRACY, CA 953 ,'6- FRANK ARNAUDO Home: ( 209 )835-2444 16505 TRAC71 BLVD Shop: ( 209 )835-0406 TRACY, CA 95376- Mobile: (209)481-5028 FOR RESTRICTED MATERIALS PERMIT USE ONLY Permit Type : Foss . Only [ ] Seasonal [X] Poss . & Use [X] Job [ ] Permittee Type : Q.A. Cert [ ] Ag . FCO [ ] Private App [X] Non-Ag [ ] NOI required 24 hours prior to application. Method: Phone [X] Box D2[1 Person [X] Modem [ ] Fax [X] - --------------------- Numb Pesticide Pesticide Pests ) Form. Method(s) Applicator( s) ----- --------------- ------------ -------- ---------------- ----------------- 1051 SEVIN Larvae Liquid Air Ground FCO Grower 1061 FURADAN Nematode Granules Air Ground PCO Grower 2000 DICAMBA Weeds Liquid Air Ground PCO Grower 2301 DI-SYSTON Aphid Liquid Air Ground PCG Grower 3824 METASYSTOX-R Aphid Liquid Air Ground PCO Grower 3830 METHOMYL Larvae Liquid Air Ground PCO Grower 3640 METHYL PARATHIO Larvae Liquid Air Ground PCO Gower 4840 ALUMINUM PHOSPH Rodents Fumigant Ground FCO Grower 55 ' STRYCHNINE Gophers Bait Ground PCO Grower 6% _ ZINC PHOSPHIDE Rodents Bait Ground PCO Grower 7860 MCPA, DIMETHYLA Weeds Liquid Air Ground PCO Grower 8041 2 , 4-DB Weeds Liquid Air Ground PCO Grower 9801 2 , 4-D AMINE Weeds Granules Ground PCO Grower 16011 PARAQUAT Weeds Liquid . Ground PCO Grower *** Pesticides, continued on next page Non-Ag Use: Conditions; PQ I understand that this permit does not relieve me from liability for any damage to persons or property caused by the use of these pesticides . I waive any claim of liability for damages against the County Department of Agriculture based on the issuance of this permit . I further understand that this permit may be revoked when pesticides are used in conflict with the manufacturer' s labeling or in violation of applicable laws , regulations and specific conditions of this permit . I authorize inspection at all reasonable times and whenever an emergency exists, by the Department ofPesticide Regulation or the County Department of Agriculture of all areas treated or to be treated, storage facilities for pesticides or emptied containers and equipment used or to be used in the treatment. [Form 33-125/v3 . 53 (Rev. 02/16/90 ) Pest ' ,ide f meat Branch] Permit Applicant : i'"GIo k .4 r_In Sign: T1t1e : Daze : Issuing Officer : .Grp► Date ;