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SAN JOAQUIN COUNTY <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-�q-3904647 <br /> County H8 District#: E ] ry <br /> SIERRA VISTA VINEYARD Expiration Date : 12/31/200f <br /> 16930 E COMSTOCK RD Effective Date : 03/17/1999 <br /> LINDEN , CA 95236 <br /> ROBERT J INDELICATO Home: (209)887-2500 <br /> 16930 E COMSTOCK RD Shop: (209)887-3665 <br /> `LINDEN , CA 95236 Fax: (209)877-3665 <br /> Mobile: (209)481-6313 <br /> ------------------------------------------------------------------------------- <br /> ------------------------------------------------------------------------------- <br /> Permittee Type Permit Type Possession NOI Method of Submission <br /> -------------- ------------ -------------- -------------------------- <br /> Private App [X] Seasonal [X] Poss & Use [X] Phone [X] Fax [X] <br /> Q A Cert [ ] Job [ ] Poss Only [ ] Box [X] Modem [ ] <br /> Ag PCO [ ] In Person [X] <br /> Non-Ag [ ] NOI required 24 hours prior to application <br /> ------------------------------------------------------------------------------- <br /> ------------------------------------------------------------------------------- <br /> `Numb Pesticide Pest(s) Form. Method(s) Applicator(s) <br /> ----- --------------- ------------ -------- ---------------- ----------------- <br /> 4840 ALUMINUM PHOSPH RODENTS Fumigant Ground PCO Grower <br /> 16011 PARAQUAT WEEDS Liquid Ground PCO Grower <br /> Non-Ag Use : <br /> Conditions : P <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 oe treated, storage <br /> facilities for pesticides or emptied containers and eqipment u ed , to be used <br /> in the treatment . [Form PR--Ec^NF-125 (Rev. 07/92) Pestici E me r c ] <br /> Permit Applicant : �C'�G�liy /N-EZSig p <br /> Title : (0 NC'A— D te : <br /> Issuing Officer : Date: <br />