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RESTRICTED MATERIALS PERMIT continued . . . . . Paget ; 6 <br /> AhNAUDO, B & B Permit# : 39-00-3902007 <br /> WORKERS SAFETY SERIES ATTACHED <br /> ---------------------------------------------------------------------- <br /> iJ A-1 through A-9 General info . ; [_] B-1 Cholinesterase Testing <br /> PERMIT CONDITIONS ATTACHED <br /> ------------------------------------------------------------------------------- <br /> [Xj P - General . <br /> [X] Q - Dicamba & Phenoxy Herbicides - Central Valley/Hazardous Area <br /> R - Dicamba & Phenoxyys - Special Hazardous Area <br /> (_] S - Metam Sodium (Vapam) <br /> [_] T - Aldicarb (Temik) <br /> [_] U - Endosulfan (Thiodan) <br /> [_j V - Rice Pesticides Program <br /> [_] Molinate (Ordram) Worker Safety <br /> [_] Attachments 1-9 : Molinate ( 1 , 6 ) thiobencarb (2 , 6 , 7 ) , carbofuran <br /> ( 3 , 6 ) , methylparathion ( 1 , 9) and malathion (voluntary: 5 , 8 ) <br /> [_] W - Methyl Bromide <br /> [_J Soil within greenhouses <br /> [_] Commodity <br /> [_] Soil injection <br /> [_] Tarped potting soil <br /> [_7 Single tree site <br /> [_] X - Furadan chemigation of grapes <br /> [_] Z - Other <br /> ----------------------------- ------------ -------------------------- <br /> -------------------------------- -- <br /> PESTICIDE SALES : GROUNDWATER PROTECTION <br /> ------------------------------------------------------------------------------- <br /> (_j 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 /> use. <br /> [_7 The material I am purchasing will be used in a Pesticide Management 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 /> copy of my restricted materials permit is attached. <br /> Material purchased: [_] Atrazine (_j Simazine [_] Bromacil <br /> [_] Diuron (_j Prometon [_] Bentazon <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 commissioner. <br /> -------------------------- ------------------ <br /> Purchaser Date <br />