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NMIZINO FAR—NIS Perm,it Number: 39-0-39021124 <br /> 29()5r: A ERNT RD County Dishict <br /> T,Q_-IV Y, ("A 95304- E pirafion Date: December 31, 2007 <br /> Effective Date: �;:• :. ; <br /> CLARK NI MUNI ) Borne awe: OFF 835-5154 <br /> 2905() RE.RN RIS Shop Plione: (209! 835-5154 <br /> TR-AC . ( A 95304- Mobile Phony: (209",483-290 <br /> Fax: <br /> Pe±ii ittee TVpe: Private Ann;ic tf or ;SOI Method of Suhoaission- <br /> Permit Type: Seasonal I'laone: X Fax: X Box: <br /> Possession: Possession & Use In Person: X :Modena: X Web: X <br /> NOI required 24 hours prior to application. <br /> Conditions: A,P,Q <br /> 3tt?nth of ymfmit f"x <br /> �O:iL:tt�Cf11.'.S1C21:. <br /> - - <br /> -—————————————————————————-- —c -------__—c ——_——————____ —_ <br /> I understand that this permit does not relieve me fresr liability for any damages to an}J perscn or pr.Terty caused <br /> by the use of these pf--tirides. I waive any claims of liability for d<unages against the County Departnumt of <br /> Agriculture based on the issuance of this permit. I further understand that this permit may be revel ed When <br /> p .ir ides are used in conflict with the marnafactura's labeling a-in violation of applicable laws,regulations and <br /> specific conditions of this permit, I authorize insper_tion at all reasonable times and whenever an eniei-genicy incists <br /> by the Department of Pesticide Regulation rA the Coi_inty Department of Agriculture of all areas treate3 or to be <br /> treai.e3l,-Acrage facilities for pesticides or emptied containers and eq_iipment used or to be used in the treatment. <br /> I have considerM alternatives and mitigation measures pursuant.to Title 3,California Code of Regulatic_ans,se-tion 6426. <br /> Taking inti:accry_int ertinomic,environment il,social,and technological factors,I have adopted those that are feasible <br /> -. would q.ibstnntially lessers any significant advers.:imprr_t on the environment. <br /> (Folin PR-1'N-1_.5 (Rev. 11106'1 PegLcide EnCoiti-'elnent Ereaet, <br /> I':rrnit Applicant: /`'I(Z- �� Signed: .__----- 1 -.— - <br /> (Flease Print) <br /> Title: C.49a _ Issue Date: _ /�.�0 6 _____ - <br /> iCa5�iiia ti <br /> Issuing Office . _ Issue Date: <br />