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F SAN JOAQUIN COUNTY <br /> 1868 E. HAZELTON AVENUE <br /> STCCKrON, CA 95205- <br /> J Web:www.co.san-joaguin.causfageomm <br /> Office: (209)468.3300 Fax' (209)468-3330 Recorder(NOI's): (209)468-3300 <br /> F41 <br /> Fi, RESTRICTED MATERIALS PERMIT <br /> Permit Number: 39-09-3901052 <br /> BULTHUIiS.RAY <br /> F', <br /> 23557 FREDRICK RD County District#: B <br /> RIPON, CA 95366- Fxlriiation Date: December 31, 2009 <br /> Effective Date: January 1"p"007 <br /> F. RAY J BULTIRTIS Home Phone: <br /> 23557 FREDRICK RD Shop Phone: - <br /> RIPON.CA 95366- Mobile Phone: <br /> FFar <br /> FPermittee Tape- QAC/QAL N01 Method of Submission.: <br /> Permit Type: Seasonal Phone: X FWC X Bor X <br /> Possession: Possession&.Use In Person: X Modem: Web: X <br /> FNOI required 24 hours prior to app-lica,tiom <br /> QAL#38307(D) 2006 <br /> Conditions: A,p,Q,W <br /> See cod of pennitfor <br /> cods descriptiow'. <br /> I understand that this permit does not relieve me from liability for ark►damages to any persons or property caused — r <br /> by the use of these pesticides. I waive arty claims of liability for damages against the County Department.of <br /> AigricWtxii-e based on the issuance of this permit. I further understand that this permit maybe revoked when <br /> Fi pesticides are used in conflict with the manufacturer's labeling or in violation of applicable laws,regulations and <br /> specific conditions of this permit I authorize inspection at all reasonable tames and whenever an emergency exists <br /> by the Department of Pesticide Regulation or the County Department of Agriculture of all areas treated or to be <br /> ktreated,storage facilities for pesticides or emptied containers and equipment used or to be used in the treatment. <br /> I have considered alternatives and mitigation measures pursuant to Title 3,California Code of Regulations,section 6426. <br /> Takia„into account economic,environmentA.social,and technological factors,I have adopted those that are feasible <br /> and would substantially lessen any significant adverse impact on the environment. <br /> [Form PR-ENP-125 (Rev. l 1106)Pesdeide EnEerrcearent Scan ] �+ <br /> Permit AppEcant4�() Signed._I�a�!fibl�rl �1 i>���✓) <br /> FiP e Print Title: 1 Issue Date:F1 <br /> ease Print <br /> Issuing officer. Issue Date: <br /> dF <br /> Fj' <br /> �f <br />