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1 <br /> SAN JOAQUIN COUNTY �. <br /> 868 E. HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Web UPJ :www. co . san-joaquin . ca. us/agcomm <br /> E-Mail : <br /> Office : ( 209 ) 468-3300 Recorder (NOI ) : ( 209 ) 468-3300 FAX: (209 )468-3330 <br /> ------------------------------------------------------------------------------ <br /> SrESTRICCED MATERIALS PERMIT PERMIT #t : 39-03-3904663 <br /> County HQ District A: G <br /> GOEHRING, HERB Expiration Date: 12Z31/200- <br /> 23755 N DEVRIES RD Effective Date : <br /> LODI, CA 95242 <br /> r <br /> HERB GOEHRING Home : (209 ) 369-7161 <br /> 23755 N DEVRIES RD- Shop : <br /> LODI , CA 95242 Fax: <br /> Mobile . <br /> ------------ <br /> Permittee Type Permit Type Possession NOI Method of Submission <br /> -------------- ------------ -------------- -------------------------- <br /> rivate App IXI Seasonal IXI Poss & Use IX.I Phone IXI Fax IXI <br /> w A Cert I I Job I I Poss Only 1 1 Box ]XI Modem 1 1 <br /> Ag PCO I I In Person IXI Web' <br /> on-Ag I I NOI required 24 hours prior to application <br /> L <br /> mon-Ag Use : None <br /> onditions: P <br /> understand that this permit does not relieve me from liability for any damage <br /> „o persons or property caused by the use of these pesticides . I waive any <br /> claim of liability for damages against the County Department of Agriculture <br /> based on the issuance of this permit . I further understand that this permit <br /> ay be revoked when pesticides are used in conflict with the manufacturer 's <br /> .abeling or in violation of applicable laws, regulations and specific <br /> conditions of this permit . I authorize inspection at all reasonable times and <br /> whenever an emergency exists, by the Department of Pesticide Regulation or the <br /> ounty Department of Agriculture of all areas treated or to be treated, storage <br /> T;acilities for pesticides or emptied containers and equipmenus d or to be used <br /> in the treatment . [Form PR-ENF-125 (Rev. 07/92) Pesticide n or me Bra h] <br /> permit Applicant : - N Sign . 22 <br /> Title: N Issue Date : L J d3 <br /> `Issuing Officer : - -y Issue Date : <br /> Page 1 <br /> r <br /> v <br /> r <br />