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i <br /> L <br /> LSAN JOAQUIN COUNTY <br /> 1868 E. HAZELTON AVENUE <br /> LSTOCKTON, CA 95205 <br /> Office : ( 209) 468-3300 Recorder (NOI ) : ( 209) 468-3300 FAX: ( 209)468-333 <br /> L RESTRICTED MATERIALS PERMIT Permit# : 39-02-390143 <br /> County HQ District# : A <br /> ZWART, REINA & JAMES Expiration Date: 12/31/2002 <br /> L 465 LINDA AVE Effective Date : 04.4�f1t/2000 <br /> RIPON, CA 95366- 1 y <br /> LJAMES ZWART Home: (209)239-253 <br /> 13396 S CASTLE RD Shop: <br /> MANTECA, CA 95336- Fax: <br /> Mobile: <br /> LPermittee Type Permit Type - Possession - NOI Method of submission <br /> -------------- --------- --- -------------- -------------------------- <br /> iPrivate App [X] Seasonal [X] Poss & Use [X] Phone [X] Fax [X] <br /> Q A Cert [ J Job [ ] Poss Only [ ] Box [ ] Modem [ J <br /> Ag PCO [ ] In Person [X] <br /> Non-Ag [ ] -- -NOI-required 24-hours-prior to applicatio; <br /> Numb Pesticide Pest (s) Form. Method(s ) Applicator(s) <br /> ----- --------------- ------------ -------- ---------------- ----------------- <br /> 1051 SEVIN LARVAE Liquid Ground PCO Grower <br /> 1360 CHLOROPICRIN NEMATODE Fumigant Fumigate PCO Grower <br /> 3850 METHYL BROMIDE SOIL/STORED Fumigant Fumigate PCO Grower <br /> 4840 ALUMINUM PHOSPH RODENTS Fumigant Fumigate PCO Grower <br /> 5733 TELONE NEMATODE Liquid Ground PCO Grower <br /> 9801 2 , 4-D AMINE WEEDS Liquid Ground PCO Grower <br /> 16011 PARAQUAT WEEDS Liquid Ground PCO Grower <br /> ti. 16891 SUPRACIDE LARVAE Liquid Ground PCO Grower <br /> LNon-Ag Use: <br /> Conditions : PQW <br /> ------------------------------------------------------------- <br /> I understand that this permit does not relieve me from liability for any damag, <br /> to persons or property caused by the use of these pesticides . I waive any <br /> jr claim of liability for damages against the County Department of Agriculture <br /> based on the issuance of this permit . I further understand that this permit <br /> may be revoked when pesticides are used in conflict with the manufacturer ' s <br /> labeling or in violation of applicable laws , regulations and specific <br /> conditions of this permit . I authorize inspection at all reasonable times and <br /> whenever an emergency exists , by the Department of Pesticide Fegulation or the <br /> I County Department of Agriculture of all areas treated or to be treated, storage <br /> 6 facilities for pesticides or emptied containers and equipment used or to be use <br /> in the treatment . [Form PR-ENF-125 (Rev. 07/92 ) Pesticide Enforcement Branch] <br /> LPermit Applicant : VSign: <br /> Title : / "'� Date: "-y (ifs <br /> `' Issuing Officer : Date: -0I I( -9D5 <br />