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- SAN ,IOAQUIN COUNTY <br /> 1868 E . HAZELTON AVENUE <br /> 6. STOCKTON, CA 95205 <br /> Web URL :w.ww. co . san-joaquin . ca . us/agcomm <br /> LE-mail : <br /> Office : ( 209 ) 468-3300 Recorder (N0I ) : ( 209 )468-3300 FAX: ( 209 ) 468-3330 <br /> - ----------------------- <br /> ---- _ _______________________________ <br /> `p 2ESTRICPED MATERIALS PERMIT .PERMIT .# : 3.9-02-3903068 <br /> _ <br /> County HQ District # : B <br /> DE PALMA - Expiration Date: _ 131/'2002 <br /> .. 18656 E HWY 120 Effective Date . 01,/14./2002 <br /> . RIPON, CA 95366- <br /> up DOMINIC DE PALMA Home : ( 209) 544-4207 <br /> 1866E E HWY 120 Shop : ( 209)838-7034 <br /> RIPON, CA 95366- Fax: 2096388011 <br /> Mobile : ( 209)531-7851 <br /> ------------------------------------------------------------------------------- <br /> ------------------------------------------------------------------------------- <br /> i <br /> Ltermittes Tvpe Permit Type Possession NOI Method of Submission <br /> Use )XI Phone IXI Fax IX) <br /> �rivate App IXI Seasonal IXI Poss 6 <br /> ' ) A Cert ) I Sob ) ) Poss Only I I Box Ix1 Modem I ) <br /> hftg POO I I In Person )X I Web I X I <br /> Non-Ag i ) NOI required 24 hours prior, to application <br /> L <br /> Non-Ag Use: Nurse <br /> Conditions : PQUWZ <br /> ------------------------------------------------------------------------------- <br /> ------------------------------------------------------------------------------- <br /> _r understand that this permit does not relieve me from liability for any damage <br /> ko persons or property caused by the use of these pesticides. I waive any <br /> I 74ab".lit.N' for r� .f. 3 rF.:^ Fin£vIT Clic ,^rri i.'.t\/ PeD Pei t%R r'„it of .R g-rj r'ttl t.'Ire <br /> erased on the issuance of this permit . I further understand that this permit <br /> .way be revoked when pesticides are used in conflict with the manufacturer's <br /> abeling or in violation of applicable laws, regulations and specific <br /> [..pnditions 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 gric•ulture of all areas treated or to be treated, storage <br /> acilities• for pestis des or emptied containers and equipment used or to be used <br /> ',p the treatment . [ o:rm P , IF-125 (Rev. 07/92 ) Pesticide Enforcement Branch] <br /> ermit Applicant : Sign: -D&Mt )IJ ic. ("AILAIA <br /> INN f <br /> Title: rPi�St N- -4_ Issue Iia te : J)Aaj , <br /> Issuing Officer : r/e [tet. Issue Date : ��/7 <br /> Faye 1 <br /> L <br /> Ip <br /> 4 <br />