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SAN JOAQUIN COUNTI---o <br /> -zoo 6 <br /> 1568 E. HAZELTON AVENUE <br /> STOCKTON, CA 95205- <br /> E-mail: Web:www.co.san-joaqum.causlagcomm <br /> Office: (209)$68.3300 Fax: (209)468.3330 Recorder(NOPs): (209)468.3300 <br /> r <br /> RESTRICTED MATERULS PERMIT <br /> CARLSON, GARY Permit Number: 39-06-3901062 <br /> 19900 S JACK TONE RD County District if: B <br /> RIPON, CA 95366- Expiration Date: December 31, 2006 <br /> Effective Date: January , <br /> GARY CARLSON Hone Phone: (209)599-3427 <br /> 19900 S JACK TONE RD Shop Phone: ( ) <br /> RIPON, CA 95366- Mobile Phone: - <br /> Fa-x: <br /> Pernnittee Type: Private Applicator NOI Medied of Sub€uissiam <br /> Permit Type: Seasonal Phone: X Fax: X Box: A <br /> Possession: Possession &Use In Person: X Modem: Web: X <br /> NON required 24 hours prior to application. <br /> Conditions- A P,Q;N <br /> See end of pemrit fur <br /> cads descriptions, <br /> ` I understand hat his permit does not relieve me froth liability for any damages to any persons cr property c%wed <br /> by the use of these pesticides. I waive any claims of liability for damages against the C.out-ity Department of <br /> Agriculture based on the issuance of rias permit. I further siderstand r1+at his permit maybe revoked wtien <br /> pesticides are used in conflict with the n-arn+factures labeling or in violation of applicable taws,regulatioia and <br /> specific condition&of this permit. I authorize inspection at all reasonable times acid wlienever an emergency exists <br /> by the Department of Pesticide Redilation or the County Depattrnent of Agricijlture of ali areas treated or to be <br /> treated,storage facilities forpesticides or emptied containers and equipment used or to be used in the treatment. <br /> .. 1FomPR-=--125 (Rev. 07192}^es icider,fercementPru?chi <br /> Permit Applicant: 4,4iC V C,� Pl-rll!l Si,-ted: <br /> [ Ease I'Maj) <br /> Tide: .Ovolvzf - Issue Date: /- 7- / <br /> (P ease Print <br /> Wiling Officer. Issue Dare: �� � <br />