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q SAN JOAQUIN COUNTY AGRICULTURAL COMMISSIONERS OFFICE41 Com: <br /> 2101 E EARHART AVE,SUITE 100 a <br /> OSTOCKTON,CA95206 <br /> ' <br /> Office: (209)953-6000 Fax: (209)953.6022 <br /> Email: stocktonag2@sjgov,org Web: wwwco•san-joaquln.w.uslagcomm <br /> RESTRICTED MATERIALS PERMIT: 39-15-3904239 <br /> ' operator: KOOYMAN,MICHAEL #3904239-2015-Verslon: 1 <br /> 22666 N.MAY RD. County District#, F f <br /> ACAMPO,CA 95220 Issued on: • �' �(� <br /> ' Valid as of, 7 <br /> Agent: MIKE KOOYMAN Expires on: 12/3112015 <br /> Primary Phone: <br /> ' 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,0,B See condition detail for <br /> code descriptions, <br /> Site Conditions: GWP-R3 - <br /> ' Regulatory Notes: qq <br /> ------------------------------------------------------------------------- ---------------------------------------------------- <br /> ' I understand that this permit does not relieve me from liability for any damages to any persons or properly 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 /> 1 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 11106)Pesticide Enforcement Branch] <br /> ' Applicant: AA t Je, JOt7t 0titJA-+el� <br /> (Name 6 TIIIe) r <br /> Applicant Signa �— = date: — —o <br /> Issuing Officer: iC1 _ti Date: <br /> ' Page 1 <br />