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6. <br /> SAN JOAQUIN COUNTY <br /> 1868 E. HAZELTON AVENUE <br /> r STOCKTON, CA 95205 <br /> ,09) 468-3300 Recorder (NOI) : (209) 468-3300 FAX: (209) 468-3330 <br /> ------------------------------------------------------------------------ <br /> L ACTED MATERIALS 'PERMIT Permit# : 39-99-3900391 <br /> County HQ District#: H <br /> .OLLERI VICTOR Expiration Date : 12/31/1999 <br /> X113 E MAIN ST Effective Date : 01/04/1999 <br /> STOCKTON, CA 95205 <br /> `ICTOR ROLLERI Home : (209) 463-8486 <br /> 5113 E MAIN ST Shop: ( ) - <br /> 4TOCKTON, CA 95205 Fax: <br /> Mobile : ( ) - <br /> Permittee Type Permit Type Possession NOI Method of Submission <br /> ------------- ------------ -------------- -------------------------- <br /> ,.�rivate App [X] Seasonal [X] Poss & Use [X] Phone [X] Fax [XI <br /> � A Cert [ ] Job [ ] Poss Only [ ] Box [X] Modem [ ] <br /> T,g PCO [ l In Person [X] <br /> fon-Ag [ ] NOI required 24 hours prior to application <br /> Vumb Pesticide Pest (s) Form. Method (s) Applicator (s) <br /> ---- --------------- ---- -------- -------- ---------------- ----------------- <br /> 6�051 SEVIN LARVAE Liquid Ground PCO Grower <br /> 2591 THIODAN LARVAE Liquid Ground PCO Grower <br /> 141 GUTHION MITES Liquid Ground PCO Grower <br /> k,830 METHOMYL LARVAE Liquid Ground PCO Grower <br /> 16971 MONITOR LARVAE Liquid Ground PCO Grower <br /> 89999 NON-PERMIT AG P WEEDS Liquid Ground PCO Grower <br /> Von-Ag Use : <br /> -onditions : PU <br /> T understand that this permit does not relieve me from liability for any damage <br /> :o persons or property caused by the use of these pesticides . I waive any <br /> 61!!laim of liability for damages against the County Department of Agriculture <br /> oased on the issuance of this permit . I further understand that this permit <br /> ay 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 /> vhenever an emergency exists, by the Department of Pesticide Regulation or the <br /> ounty Department of Agriculture of all areas treated or to be treated, storage <br /> acilities for pesticides or emptied containers and equipment used or to be used <br /> in the treatment . [Form PR-ENF-125 (Rev. 07/92) Pesticide Enforcement Branch] <br /> ✓Permit Applicant : Sign: <br /> Title: Date: <br /> b" <br /> Issuing Officer: Date: <br /> HAARE 2.ABJE TO LOCATE SIGNED ORIGINAL 1999 PERMIT. <br /> ZEL Rc�GALL�FICE ASSISTANT SPECIALIST <br />