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o? STRICTER `tATERT A T S PE-RM" cr..nt • Page 3 <br /> RLSON, GARY <br /> � Permit +#' : 39-98-390106= <br /> -------------------= WpIRgERS SAFETY SERIES ATTACHED <br /> ---------------------------------------------------=-------------------------- <br /> riyl A-Y. thr-)ugh 1-9 "-en-ral _info • t i_i B-i Cholinesterase Testing <br /> _______PER_f IT CONDITIONS ATTACHED <br /> ----------= --------------------- <br /> ----------------------------- <br /> r� l P - Central <br /> IT ' n - Diramba & Phenony Herbicides - Central Valley/Hazardous Area <br /> Lr_1 R - Dicamba x Phenonys - Special Hazardous Area <br /> [ l S - Metam Sodium (I'apnm) <br /> T - ":ldicarb (Temih) <br /> [_; U - Endosulfan (Thiodan) <br /> [_', 1, - Rice Pestir.ides Program <br /> (_? Molinate (Ordlr.am) Worl-Ar S.^;fety <br /> [_1 Attachments 1-9 : Molinate fl , 6 ) thiohencarl? (2 , 8 , 7 ) , ra.rbofuran <br /> meth;-lpH.rathion (.4 , 9 ) and -malathion (1rollintar7-: 5 , 8 ) <br /> rv,-1 W - Methyl Bromide <br /> [-1 Sn; l w; th; n 's re enl.�Ot).Se <br /> L (_] commodity <br /> r ? Soil inection <br /> [-� <br /> Single <br /> n0 + n'+ SO11 <br /> Ij — - G'� Single trer':i S3}e <br /> Itll` r ' Y k'L;ra.dan chemiaeti.on of gra:nes <br /> r 7 _ Other - <br /> ------------------------------------------------------------------------------- <br /> PESTICIDE SALES : GROUNDWATER PROTECTION <br /> ----- ------------------------------- ---------- <br /> L (� The material I am hurrba. inS l<+? l.l- not be used in a Pesticide ManaQnmen.t. <br /> Zone ( a.s describer. Jn Seot,ion 6802 , Ti4tle 3 California Code of Reg- <br /> L ulat,ion�. ) for agricultural , outdoor inSti.tittirina.l_ or outdoor .industrial <br /> Lyse. <br /> r 1 The material. I am purchasing -ill. he used in a Pe?ticide Manaeemen.t. Zone <br /> fay described in Section 6802 , Title 3 , California Code of Regulations ) <br /> L Cor % g-ir r tural , outdoor in^titvtional or oiltdool ind'.istrial use and <br /> ^_O?;' Of m;' restricted mrterl£^..is permit is attached. <br /> L Material purchased: .Atrazine r_? sim<tzine [-] Bromacil <br /> [_] Diur O:i [_2 Drome+n-, [ <br /> I Certifz -unclel' -'f L 5 Pat the for-:'-- Jing tatemerit is true, <br /> and that I will not ^ .ylan-- —t,,isl Section r800r ) in ant- <br /> Pesticide Management ZDne f _ 1S l .ult.tre , outdoor ins titutignel or <br /> outdoor industrial t'St 4 - ,sccordan with a permit i-suer4 b:- tl <br /> county agricult ,-al comri oner or the director in a count; i .hi.r.h <br /> there i- no commissioner. <br /> _ C>/ <br /> d <br /> �„ - Date <br />