Laserfiche WebLink
Restricted Materials Permit Conditions v Page# : 1 of 3 <br /> L The-Following-Conditions-Apply-To- Permit#_-39_02_3900096 <br /> WORKERS SAFETY SERIES ATTACHED <br /> ---------------- <br /> --------- <br /> ------------------ <br /> ------------------------------------ <br /> [X] A-1 through A-9 General Info. ; [_] B-1 Cholinesterase Testing <br /> PERMIT CONDITIONS ATTACHED <br /> -------------------------------------------------------------------------------- <br /> t [X] P - General <br /> L. [X] Q - Dicamba & Phenoxy Herbicides - Central Valley/Hazardous Area <br /> [_] R - Dicamba & Phenoxys - Special Hazardous Area <br /> L [_] S - Metam Sodium & Metam Potassium <br /> [_] T - Aldicarb (Temik) <br /> [_] U - Endosulfan (Thiodan) <br /> [_] V - Rice Pesticides Program <br /> [_] Molinate (Ordram) Worker Safety <br /> L [_] Attachments 1-9: Molinate (1 , 6) thiobencarb (2,6,7 ) , carbofuran <br /> (3, 6) , methylparathion (9,9) and malathion (voluntary: 6,S) <br /> L [X] W - Methyl Bromide <br /> [_] Soil within greenhouses <br /> [_] Commodity <br /> [_] Soil injection <br /> 6. _] Tarped potting soil <br /> [_ Single tree site <br /> [_] X - Furadan chemigation of grapep <br /> [X] Z - ------------ <br /> r --------------- -- --- Q -3z �:��=4% ', Ti37�S= ---------------__- <br /> PESTICIDE SALES: GROUNDWATER PROTECTION <br /> ------------------------------------------------------------------------------- <br /> M The material I am purchasing will not be used in a Pesticide Management <br /> L one as described In Section 6bO2, Title 3,Cali orn a Cdde o eg- "— <br /> ulations) for agricultural, outdoor institutional or outdoor industrial <br /> use. <br /> [_] The material I am purchasing will be used in a Pesticide Management Zone <br /> w (as described in Section 6802, Title 3, California Code of Regulations) <br /> for agricultural, outdoor institutional or outdoor industrial use and a <br /> copy of my restricted materials permit is attached. <br /> ` Material purchased: [_] Atrazine [_7 Simazine [_] Bromacil <br /> [_] Diuron [_I Promet.on [_7 Bentazon <br /> ►+ I Certify under penalty of perjury that the foregoing statement is true, <br /> and that I will not apply any material listed in Section 6800(a) in any <br /> Pesticide Management. Zone for agriculture, outdoor institutional or <br /> ` outdoor industrial uses except in accordance with a permit issued by the <br /> county agricultural commissioner or the director in a county in which <br /> there is no commissioner. <br /> Purchaser Date <br /> 6. <br />