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SAN JOAQUIN COUNTY ZCp2 <br /> 1868 E. HAZELTON AVENUE / <br /> STOCKTON, CA 95205 <br /> Office: ( 209)468-3300 Recorder (NOI) : (209 )468-3300 FAX: ( 209 )468-3330 <br /> ------------------------------------------------------------------------------- <br /> RESTRICTED MATERIALS PERMIT Permit#:,, 39:-02-390.3311 <br /> County HQ District# : C <br /> MURPHY RANCH' t ExpirationDate:: 12/31/2002 <br /> 2549 BEECHER RD Effective Date <br /> STOCKTON, CA 95215 <br /> TIM SUNBURY Home: (209 )931-4382 <br /> 2549 BEECHER RD Shop: (209 )886-5493 <br /> .. STOCKTON, CA 95215 Fax: <br /> Mobile: (209 )969-9889 <br /> ------------------------ ------------ ----------- ------ <br /> ------------------------- -------- ---------- ------- <br /> Permittee Type Permit Type Possession NOI Method of Submission <br /> -------------- ------------ -------------- -------------------------- <br /> Private App [ ] Seasonal [X] Puss & Use [X] Phone [X] Fax [X] <br /> Q A Cert [ J Job [ ] Poss Only [ ] Box [X] Modem [ ] <br /> Ag PCO [X] In Person [a] <br /> Non-Ag [ ] NOI required 24 hours prior to application <br /> ----------------------------------------- ---- <br /> .. Numb Pesticide Pest(s ) Form. Method(s) Applicator( s) <br /> ----- --------------- ------------ -------- ---------------- ----------------- <br /> 1041 CAPTAN DUST FUNGI Dust Air Ground PCO Grower <br /> 1051 . SEVIN LARVAE Liquid Air Ground PCO Grower <br /> 1061 FURADAN NEMATODE Liquid Other PCO Grower <br /> 1360 CHLOROPICRIN NEMATODE Fumigant Fumigate PCO Grower <br /> 3141 GUTHION MITES Liquid Air Ground PCO Grower <br /> 3830 METHOMYL LARVAE Liquid Air Ground PCO Grower <br /> 3850 METHYL BROMIDE SOIL/STORED Fumigant Fumigate PCO Grower <br /> 4840 . ALUMINUM PHOSPH RODENTS Fumigant Fumigate PCO Grower <br /> 5540 STRYCHNINE GOPHERS Bait Ground PCO Grower <br /> 6260 ZINC PHOSPHIDE RODENTS Bait Ground PCO Grower <br /> ****** PESTICIDES CONTINUED ON NEXT PAGE ****** <br /> Nun-Ag Use : <br /> Conditions : PQW <br /> ---------- ------- <br /> _________________________________________________________________- <br /> I understand that this permit does not relieve me from liability for any damage <br /> to persons or property caused by the use of these pesticides . I waive any <br /> 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 Regulation or the <br /> County Department of Agriculture of all areas treated or to be treated, storage <br /> facilities for pesticides or emptied containers and equipment used or to be user <br /> in the treatment. [Form PR-ENF-125 (Rev. 07/92 ) Pesticide Enforcement <br /> ,flBranch] <br /> Permit Applicant: ( im 5ur,15 )R`( Sign: AI'm <br /> Title: M4n4!5,e. Date : <br /> Issuing Officer: w ✓�� Date : - 1f7-j2J <br />