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SAN JOAQUIN COUNTY AGRICULTURAL COMMISSIONERS OFFICE <br /> A� 2101 E EARHART AVE, SUITE 100 <br /> STOCKTON, CA 96206 <br /> Office: (209)953-6000 Fax: (209)953.6022 <br /> Email: stocktonag2@sjgov.org Web: www.oe.san•]osquln.ca.us/agcomm <br /> ' RESTRICTED MATERIALS PERMIT: 39-16-3904239 <br /> Operator:K00YMAN,MICHAEL #3904239.2016-Version: 1 <br /> 22666 N.MAY RD. County District#:F'//�//� <br /> ' ACAMPO,CA 95220 Issued on: <br /> Valid as of: <br /> Agent:MIKE KOOYMAN Expires on:12131/2016 <br /> ' Primary Phone. <br /> Alternate Phone: <br /> Mobile Phone: <br /> Fax: <br /> ' Type of Use:Agricultural Use Notices Of Intent required 24 hours prior <br /> Pesticide Possession:Possession and Use to application of pesticide containing <br /> Permit Duration:Seasonal restricted materials <br /> ' Permit Conditions:A,P,B,QL See condition detail for <br /> code descriptions. <br /> ' site Conditions;GWP-R3 <br /> Regulatory Notes: <br /> ---------------------------------------------------------------- ------------------------ <br /> ------- ------ <br /> - <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 on <br /> ' the issuance of,this permit. I further understand that this permit may be revoked when pesticides are used in conflict with <br /> the manufacturer's labeling or in violation of applicable laws, regulations,and specific conditions of this permit, I authorize <br /> inspection at all reasonable times and whenever an emergency exists by the Department of Pesticide Regulation or the <br /> County Department of Agriculture of all areas treated or to be treated,storage facilities for pesticides or emptied <br /> ' containers and equipment used or to be used in the treatment. I have considered alternative and mitigation measures <br /> pursuant to Title 3,California Code of Regulations, section 6426. Taking Into account economic,environmental, social, <br /> and technological factors, I have adopted those that are feasible and would substantially lessen any significant adverse <br /> Impact on the environment. <br /> ' [Form PR.ENF-126(Rev 11106)Pesticide Enforcement Branch] <br /> Applicant: t (?- `L`)()' +/jGUf� e2 <br /> ' (Name&Tlllo) <br /> Applicant Signa rr' -- Date: J- j 2, - � <br /> ' Issuing Officer: 4 — Date: <br /> 1 <br /> Page 1 <br />