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Fl. <br /> estr•icted Materials Permit Conditions Page# : 1 of 3 <br /> The Following Conditions Apply To Permit# : 89-05--3900506 <br /> FWORKERSSAFETYSERIES ATTACHED------------------------------------------------------- <br /> [Xi A.-1 through A-9 General Info. C_] B-i Cholinesterase Testing <br /> FCONDITIONS ATTACHED <br /> [X] P - General <br /> [X] Q - Dicamba &. Phenoxy Herbicides - Central Valley/Hazardous Area <br /> fil <br /> R - Dicamba & Phenoxys - Special Hazardous Area <br /> [_, S .- Metam Sodium & Metam Potassium <br /> [_] T - Aldicarb (Temik) <br /> [_] U - Endo:sulfan (Thiodan) <br /> [_] V - Rice Pesticides Program <br /> [_] Molinate (Ordra.m) Worker Safety <br /> [_] Attachments 1-9: Molinate ( 1 , 6) thiobencarb (2,6,7 ) , narbofuran <br /> (3, 6) , methylparathion (4,9) and malathion (voluntary: 5, 8 ) <br /> F LX] W -- Methyl Bromide <br /> [_] Soil within greenhouses <br /> t L Commodity <br /> [_] Soil injection <br /> [-] Tarped potting soil <br /> [_] Single tree site <br /> F` C_] X -- Fur adan chemigat ion of grapes <br /> C_] Z -. Cather <br /> PESTICIDE SALES: GROUNDWATER PROTECTION <br /> �� [�7 The material I-am purchasing will not be used in a Pesticide Management - <br /> Zone (as described in Section 6802, Title 3. California Code of Reg- <br /> ulations ) for agricultural. , outdoor institutional or outdoor industrial. <br /> F uue . <br /> [_] use material F am purchasing will be used in a Pesticide Managein,ent Zone- <br /> (as described in Section 6802 , Title 3, California Code of Regulations) <br /> for agricultural , outdoor institutional or outdoor industrial use and a <br /> Fj copy of my restricted materials permit is attached. <br /> Material purchased: C_i Atrazine [_] Simazine [_] Bromac-il <br /> C_] Diuron [ ] Prometon C_7 Rentazon <br /> I Certify under penalty of perjury that the foregoing statement is true , <br /> and that I will not apply any material listed in Section 6800(a) in any <br /> Pesticide Management Zone for agriculture, outdoor institutional or <br /> outdoor industrial uses except in accordance with a permit issued by the <br /> county agricultural commissioner or the director in a county In which <br /> there is no con-missioner. <br /> --------------------- <br /> ----- ---- _ -�.__----------- F <br /> Purchaser Date <br />