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SU0008066 SSCRPT
Environmental Health - Public
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SU0008066 SSCRPT
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Last modified
5/7/2020 11:33:20 AM
Creation date
9/6/2019 10:22:14 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0008066
PE
2622
FACILITY_NAME
PA-1000008
STREET_NUMBER
10850
Direction
N
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
LINDEN
APN
06506002 03
ENTERED_DATE
1/25/2010 12:00:00 AM
SITE_LOCATION
10850 N JACK TONE RD
RECEIVED_DATE
1/25/2010 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\J\JACK TONE\10850\PA-1000008\SU0008066\SSC RPT.PDF
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EHD - Public
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.Y.. ^ SAN MQUIN COUP <br /> 1868 R RA2 EI.TON AVENUE <br /> -x 2006 <br /> STOCKTON,CA 95205- <br /> Frslnail: Web-.www.co.sanyoagtria.ca.usfagcom <br /> Office:(209)468-3300 FwL.(309)468-3330 Recorder(NON), (209)468-3300 <br /> �f <br /> R1gsTRICrBD IVIATBB.TALS PBRMTf <br /> FUGAZL,JOHN A PermitNumber: 39-06-3900153 <br /> F P O BOX 509 County District# D <br /> LINDEN, CA 95236- Expiation Date: December 31, 2006 <br /> Effective Date: J <br /> 30,10 o Com.' <br /> JOHN A FUOAZI Home Phone: (209) 887-2147 <br /> 17400 E MCHWAY 26 Shop Phone: (209)887-2147 <br /> LINDEN,CA 95236- Mobile Phone: (209)470-7699 <br /> Fax: <br /> Permittee Type: Private Applicator NOI Method of Snbmssion: <br /> r Permit Type: Seasonal . Phone: X Fax: X Bor X <br /> ' Possession: Possession&Use In Person: X Modem: X Web: <br /> NOI required 24 hours prior to application- <br /> 1 . <br /> Conditions: A,P,Q.W, <br /> See and of Petah for <br /> code descriptions. <br /> I understand that this permit does not relieve me from liability for any damages to any persons or property caused <br /> by the use of these pesticides. I wive any claims of liability for damages against the County Department of <br /> Agriculture based on the issuance of this permit I further understand that this permit may be revoked when <br /> pesticides are used in conflict with the manufacturer's labeling or in violation of applicable laws,regulations and <br /> specific conditions of this pemvt I authorize inspection at all reasonable times and whenever an emergency exists <br /> by the Department of Pesticide Regulation or the County Department of Agriculture of all areas treated or to be <br /> treated,storage facilities for pesticides or emptied containers and equipment used or to be used in the treatment, . <br /> [Form PR-ENF-125 (Rev. 07192)Pesticide Enforcement Branch] <br /> Permit Applicwt V pu-(pZl". Sig�led r <br /> (Please Nift <br /> Title: 0 N�— Issue Date: <br /> please <br /> Issue O#$cer, Issue Date: <br /> Page 1 <br />
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