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< SAN JOAQUIN COUPF?`Y <br /> . 1$6` 7. HAZELTON AVENGE - <br /> L. Stn TON, CA 95205 <br /> Web URL:www.co.san-joaquin.ca.us/agcomm <br /> E-Mail : <br /> Office : (209') 466-3300 Recorder (NOI) : (209) 465-3300 FAX: (209) 465-.3330 <br /> ------------------------------------------------------------------------------- <br /> ,,.P.ESiRICTED MATERIALS PF-P.MIT PERMIT #: 39- -3904663 <br /> County HQ District #: G <br /> GOER_RING, HERB Expiration, Date: <br /> 23755 N DEVRIES RD Effective Date II �L{I Q <br /> LODI, CA 95242 <br /> 6. <br /> HERB GOEHRING Home: (209)369-7161 _ <br /> 3755 N DEVRIES RD shop: <br /> LODI, CA 95242 Fax: <br /> Mobile <br /> Permittee Type Permit. Type Possession NOI Method of Submission <br /> -------------- ------------ ------------- -------------------------- <br /> Private App IXI Seasonal IXI Pass 5 Use IXI Phone IXI Fax . M <br /> Q A Cert { I Sob I I Poss Only I I Box IXI Modem I I <br /> ,.Ag PCO I { PCO Only 1-1 In Person IXI Web I I <br /> Non-Ag I { NOI required 24 hours prior to application <br /> Non-Ag Use: None <br /> Conditions: A , P <br /> L See end of permit for <br /> code descriptions. <br /> f = = = = <br /> understand that permit does me for <br /> Iany damage <br /> h-to 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 /> teased on the issuance of this permit. I further understand that this permit <br /> may be revoked when pesticides are used in conflict with the manufacturers <br /> labeling 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 /> County Department of Agriculture of all areas treated or to be treated, storage <br /> facilities for pesticides or emptied containers and equipment used or to be used <br /> in the treatment. [Form PR-ENF-125 (Rev. 07/92) Pesticide Enfor ent ranch] <br /> ' <br /> Permit Applicant. )4{ /)D y� Sign: <br /> LTitle: Issue Date: <br /> Issuing Officer: Issue Date: <br /> L <br /> Page 1 <br /> L <br /> L <br />