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r ` SAN JOAQUIN COUNTY 1868 E . HAZELTON AVENUE -- STOCKTON, CA 95205 r Web URL : www. co . san-joaquin. ca . us/agcomm E-mail : office : ( 209 ) 468-3300 Recorder (NOI ) : ( 209 ) 468-3300 FAX: ( 209 ) 468-3330 ----------------------- RESTRICTED MATERIALS PERMIT PERMIT 9 : 39-03-3902114 County HQ District # : J THOMING-WILLIAMS Expiration Date : 12/31/200= 33600 K_OSTER RD Effective Date : TRACY, CA 95376- RICHARD HOVE Home : ( 209 )835-2792 33600 KOSTER RD Shop : - ( 209 )835-2792 TRACY, CA 95376- Fax: 2098364609 Mobile : 2096785841 Permittee Type Permit Type Possession NOI Method of Submission r -------------- ------------ -------------- -------------------------- Private App IXi ._ Seasonal IXI Poss & Use IXI Phone IXI Fax IXI Q A Cert I I Job I I Poss Only I I Box I I Modem I I Ag PCOI I In Person IXI Web I I r Nan-Ag I I NOI required 24 hours prior to applicatior ►. Non-Ag Use: None Conditions : PQ, PA-5001201 , expires 12-31-2003 r I understand that this permit does not relieve me from liability for any damage to persons or property caused by the use of these pesticides . I waive any claim of liability for damages against the County Department of Agriculture based on the issuance of this permit . I further understand that this permit may be revoked when pesticides are used in conflict with the manufacturer ' s labeling or in violation of applicable laws, regulations and specific conditions of this permit . I authorize inspection at all reasonable times and whenever an emergency exists, by the Department of Pesticide Regulation or the County Department of Agriculture of all areas treated or to be treated, storage facilities for pesticides or emptied containers and equipment used or to be usec in the treatment . [Form PR`-1E`NF-125 (Rev . 07/92 ) Pesticide Enforcement Branch] r �Ln�neY� Moue Sign : - �- Permit Applicant : u . Title: �.M Issue Date : r P Issuing Officer : Issue Date : Page 1 r r 1�