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' SAN JOAQUIN COUNTY AGRICULTURAL COMMISSIONERS OFFICE <br /> _ o• eee 2101 E EARHART AVE, SUITE 100 <br /> y --••1 STOCKTON, CA 95206 <br /> ' Office: (209) 953-6000 Fax: (209)953-6022 <br /> d P Email: stocktonag2@sfgov.org Web: www.co.san-joaqu1n.m.us/agwrnrn <br /> / b <br /> RESTRICTED MATERIALS PERMIT: 39-14-3904239 <br /> Operator: KOOYMAN,MICHAEL #3904239.2014-Version: 1 <br /> ' 22666 N. MAY RD. County District#: F <br /> ACAMPO, CA 95220 Issued on: J1 s-//-'a <br /> Valid as of: / / ,rf// gL <br /> ' Agent: MIKE KOOYMAN Expires on: 12/31/2014 <br /> 1,,IGINAL Primary Phone: <br /> ' 4'�y Alternate Phone: <br /> Mobile Phone: <br /> Fax: <br /> Type of Use: Agricultural Use Notices Of Intent required 24 hours <br /> ' Pesticide Possession: Possession and Use prior to application of pesticide <br /> Permit Duration: Seasonal containing restricted materials <br /> ' Permit Conditions: A. P, Q. B See condition detail for <br /> code descriptions, <br /> Site Conditions: GWP-R3 <br /> ' Regulatory Notes: <br /> ' I understand that this permit does not relieve me from liability for any damages to any persons or property caused by the <br /> use of these pesticides. I waive any claims of liability for damages against the County Department of Agriculture based <br /> on the issuance of this permit. I further understand that this permit may be revoked when pesticides are used in conflict <br /> ' with the manufacturer's labeling or in violation of applicable laws, regulations, and specific conditions of this permit. I <br /> authorize inspection at all reasonable times and whenever an emergency exists by the Department of Pesticide <br /> Regulation or the County Department of Agriculture of all areas treated or to be treated, storage facilities for pesticides or <br /> emptied containers and equipment used or to be used in the treatment. I have considered alternative and mitigation <br /> ' measures pursuant to Title 3, California Code of Regulations, section 6426. Taking into account economic, <br /> environmental, social, and technological factors, I have adopted those that are feasible and would substantially lessen <br /> any significant adverse impact on the environment. <br /> [Form PR-ENF-125(Rev 11/06) Pesticide Enforcement Branch] <br /> Applicant: K 0 AJ � <br /> (Name&TIUe) <br /> ' Applicant Signature. Date: g <br /> ' Issuing Officer: Date: <br /> T� <br /> 1 <br /> ' Page 1 <br />