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ihR F Git :r�[T i_ <'i s� =:fit' Cor '- � <br /> Page <br /> ?;UNEG ANGELO Permit #: 39-98-390009 <br /> L [XI A-a through to-9 General Info. C_3 E-i Cholinesterase Test—,1 <br /> ;^, i.ACHE1_._---- <br /> �ylL . ! 7.;! i'i e.ai^.bl� i?: 9'i-;ei,iol.y -*rbl_s }cS Central Va•ii2y tr!a2dr CoLdS 's-`9rC <br /> [-i R - Dicamb a +& Fher:JS;'ys - Spe=ial Ha=-aril c-us Area <br /> 4 Sv <br /> ;;v c.p2.zf1?1 <br /> �o15Lit1an. (T h1. -f;an ) <br /> i..3 l,: - RiCe PE:St .Clue'> Program <br /> ( -_] ^iolinate (Ordrasz:, Worker- :Safety <br /> L [ Attachments 1-9-.. Molinate ( 1,6) thiobencarb (2,6,7'j , Carbo•furair <br /> ;,3,6) , methylparathion (499) and malathion [voluntary: 5, ,t <br /> CY3 #1A - Methyl Bromide <br /> f Soil within greenhouses <br /> C ] . C-Jmmod i tv . <br /> 3 f.o _l irijeCti.oGi <br /> arped ptotti.ng soil . <br /> r i Single tree 544..e <br /> C_3 - Furadan chemigation of grapes <br /> c, <br /> PESTICIDE ::ALES; GROUNDWATER PROTECTION <br /> ------------------------------------------------------------------------------------ <br /> C_3 The material I am purchasing will not be used in a Pesticide Management <br /> E <br /> Zone Cas described in Section 6802, Title 3, California Code of Reg- <br /> for agricultural , outdoor institutional or outdoor industrial <br /> use. <br /> Thcti mat=r'ial I ,,in purchasing will be used in a Pesticide Management Zone <br /> 6, fas described in Section 6802, Title 3, California Code of Regulations) <br /> ff.:r a:g:ricultf_sral , outdoor institutional or outdoor industrial use and <br /> copy of my restricted materials permit is attached. <br /> M.....terial F;;Archasad— L_3 4trn._ine `_3 Simazine [_J Promacii <br /> [_] Diuron i_7 Pr-omcton ir'enta­on <br /> l <br /> L I C:r_rtif_. u:der- penalty of perjury that the foregoing statement is 'true, <br /> and that I will not apply any material listed in Section 6800(x) in any <br /> P^r..s: .icis Management Zone -for agriculture, outdoor institutional or <br /> os+ <br /> outdoor industrial s:e'_. e.;cept in accordance with permit issued by the <br /> ciamfni5slorier or, the di-rector td h iCn <br /> there IS no corismi_.s�_oner. <br /> Purchaser Date <br />