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FU <br /> Ft U EZ a g 0 om-P'! <br /> Vi ! ju _ <br /> e ' <br /> Penorder <br /> RESTRICTED MATERIAIS PERMIT pERMIT m ! 19.03.?9 02127 <br /> Zl12/11Z200D <br /> Date <br /> TRACY. CA qnmo- <br /> Home : 12071a?6-0005 <br /> Shop : <br /> Fax : <br /> CA 95354-- mobile 1 <br /> MathQd U0 <br /> ropwintee Typi;- Permit Type POSEenslan <br /> ---------------- ---------- <br /> I.... <br /> ! X1 poes & Use Phone 1XI <br /> A Cayt job Pon. only Ban 1 1 Modem ixt <br /> in Person jyj Web, 1XIr <br /> Ag PGO No! requized 24 houra pr "Or W a=iicati" <br /> use i Non.- <br /> e (conditionsi TL;W, PA-3900401 - PA.R99=�2 <br /> unllsrRtand that this permit Meg n" welisve me f,,, liabilit,y- for any damagr,- <br /> to pareons or propertycauaed by the nee of these peotiCidear 1 waive any <br /> par-mant of AgriculUUM <br /> against the Counn- <br /> ty W,PW . ,, <br /> fMown 0j liability for aamageS <br /> losed on ths issuance of thim permit . I further underOtand that thie permit. <br /> ,2,,, b, ,,,ked when pesticideo ere used in contlict ,--jith the <br /> labeling or in violation 'of applicable iaw2 . regulations and <br /> 1 authorize inapaction at all reasonable timee m-- <br /> of this Psrmit - ' of pesticide RegulatiOn Or th-,Z� <br /> whenevex an emergency *Xisae , by the Dapartmen'-0 e <br /> t 11 ar&as treated or to n tcested . <br /> ,,tj,d containera and equipmen, uged or W be us1w,2 <br /> Wev . 07,921 pegticide Entorcsment Branchj <br /> treatment . tForm. <br /> FP' <br /> S i--g3 1 <br /> Permit Applicant ; --C - <br /> Title : .0.0;vwc. <br /> ► -7 lei <br /> 1STUe Datc� <br /> Page <br /> F, <br /> C, <br />