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Peindme:CARLSON, GARY PelmitNumber: 39-06-5901'411, <br /> Doe dptton of conditions on dila Pernnlr, <br /> Canditlon ID 6zsctIptfan <br /> A Permit Cond.Talite of Contents <br /> ` A-PERMIT CONDITIONS-TABLE.OF CONTENTS <br /> WCJFSLERS SAFETY SEFM ATTACHED <br /> [ <br /> IA-1 through A-1 I General Information <br /> PMvRT CONDTTONS ATTAO'= <br /> v [Xj P-General <br /> [ ] Q-Dicamba&Phenoxy Herbicides-Central ValleylHazardous Asea <br /> [ I R- Dicamba&Phenosys-Special Hazardous Area <br /> [ ] <br /> S- Metam Sodium&Metam Potassium <br /> ` [ j T- Aldicarb(Temik) <br /> [ ] TJ- Endosulfan(Thiodan) <br /> [ I <br /> V- Rice Pesticides Program. <br /> r [ ]-Molinate(Ordram)Wo&,er Safety(A) <br /> [ I-Attachments l-1 G: Molinate(1,6),Thiobencarb(2,6,I), <br /> Methylparathion(3,9),Seepage Control(5), <br /> Propanii(10)and Malathion(voluntary:4,£S). <br /> ` [✓]W-Methyl Bromide <br /> ( j-Soil within greenhouses <br /> [ ]•Commodity <br /> [ I-Soil iniection <br /> [ ]-Tarped potting soil <br /> Single tree site <br /> ( ]X-Furadan chemigation of grapes <br /> [ j Y- 1,3 -Dichloropropene <br /> [ l Z•Other <br /> PESTICIDE SALES: GROUNDWAT R PROTF LOlr <br /> (/j The material I ern purchasing will not be used in a Pesticide Management 7.0-tne(as described in Section 6802, <br /> Title 3,California Code of Regulations)for agricultural,outdoor institutional or outdoor industrial use, <br /> ( j The material I am purchasing will be used in a Pesticide Management Zone(as described in Section 6802,Title s, <br /> .� California Code of Regulations)for agricultural,outdoor institutional or outdoor industrial use and a copy of my <br /> restricted materials permit is attached <br /> Material purchased; ( ] Atrazine ( ] Simazine [ I Bromacii <br /> [ j Diuron [ j Prometon [ I Bentazezn <br /> I certify under penalty of pe luty Clot tlne fot egoing statement is tiue,and that I will not apply airy rnAe•ial listed in <br /> Section 6800(a)in any Pesticide Management Zone for agriculture,outdoor institutional or outdoor industrial uses <br /> except in accordance with a permit issued by tl:e director in a county in <br /> which there is no commissioner. <br /> 6. <br /> Pur%hssee <br /> J7o � <br /> Date <br />