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ki.ESTr ICti D MATERI'LS PERLxIl CQixe, ., Pane 6. <br /> .ARNAUDO, H & H Ferm" t 9 . 39-99-3902007 <br /> W©1; iPnS SiiFET r <br /> SERIFS ".`I`T:iCHr,D <br /> iXJ A-1 through A-9. .General Info . E-1 Cholinesterase Testring r` <br /> PERMIT CONDTTIdNS .ATTACHED <br /> Vin] P _ venera <br /> (X] Q - :Dicamba. at' Phenoxy' Herbicides. Central valley/Hazardous Area. <br /> L_} R, .- 'Dicamba. ac ,Phenoxys : 7 S1.1cOial, Hazardous.-iii ea <br /> F <br /> S fe L.RamSodium' <br /> , <br /> -- '�'x (L'apam) '. <br /> L_J T - Aldicarb {Temiki <br /> UEel' -Lfen (Thiodan) <br /> L-] V - RiC.e Pesticides Program <br /> (TJ Holinate (Ordram) Wormier Safety. <br /> Lr J =Attachments. 1-`9 : iMolinate .( 1 , 5 ) thio'benda:rb ('2 , C-, , 7) , carbofiiran <br /> :( 3 , 5 �', lfl@thylpar a.thion (4.39 ) .and .malathion (-voluntary; .5 , 8 ) <br /> L_J iii -. .Methyl Droit-lid. <br /> �} Soil 'within greenhouses " <br /> L,J CumI-11odity <br /> L_J : soil injcctlol - <br /> L_ J Tarped potting 5011 <br /> L�J -Single tree site <br /> -F-arad-an chemigationx of grapes <br /> - .O they <br /> ----------------- <br /> PESTICIDE SALES : GROUNDWATER -PROTECTION -- <br /> .�] The material I am purch4sina will not be . used in. a Pesticide: -Management <br /> cone (as L described Ili' Sect-Lon ' 680.2 ,- Title 3 , California Code of "Reg-' <br /> 11 6tid2i5 / for agriCllltura'I j outdoor institUtipnal .or .out-door industrial <br /> use . <br /> [_J The 'mat'er` a! I am. Purchasing will be used in'. a, Pest.icides Management Zone <br /> (as' d e s 6.rIL bed .in Section' 68.02 , .Title 3 ," California; Cade of Regulations ' <br /> for agricultural ,.. outdoor institutional or o-utdoor . 'indilstrial 'use and* .a <br /> copy- of. my. restricted materials. permit is attached. <br /> riaterial.. purchaa d.-:... L�] atrazine .j_� Samazirxe L -] Brar�acii . <br /> Lr] Diuron [_] Prolaetan [_]. San'taz6n <br /> I' Certify .udder -pE rnal.ty of perjury that the foregoing statement i.s true, <br /> and that I will not apply any material listed in Section 5800(a). in any <br /> estici,d.e Management Zone for agriculture,. . outdoor institutional- or <br /> outdoor industrial uses except in accordance with a permit ..issued . by the <br />[ couhlty agricultural. cGmmissioner or. the. director - in .a county in which. <br /> -there .is no c'omri,ssi.oner. <br /> ---------- r .. 'Da.te^- .--- . <br /> I <br /> f <br />