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SAN JOAOUIN COUNTY <br /> 1868 E. HAZELTON AVENUE <br /> STOCKTON, CA 95205 S30 <br /> Office: (209)468-3300 Recorder (NOI ) : (209 )468-3300-- FAX :-(205- ----- <br /> Permit#: 39-02-3904929 <br /> RESTRICTED MATERIALS PERMIT County HO District# : F <br /> r AGUER NABORI PROPERTIES Expiration Date: 12//31//2002 <br /> 915 17TH ST Effective Date : 3/12p12d0 / <br /> r, MODESTO, CA 95354- <br /> Home: (209)524-2770 <br /> MIKE BURDEN Shop: (209)74B-11922 - <br /> 915 <br /> 209)748-5922915 17TH ST —y,Ei;x : <br /> ` MODESTO, CA 95354- Mobile: (209)604-8707 <br /> Permit Type Possession NOi Method of Submission-- <br /> ------ <br /> EXI <br /> .. Permittee Type _y_p Fax [X] <br /> Private App CX] Seasonal CX] se CXj Phone rX] Modem L ] <br /> O A Cert C ] posy Only Box In Person CX ] <br /> Ag PCO C j 101 required 24 hours prior-to-application <br /> Non-Ag ---------------=----------------------- <br /> Form. Method (s) Applicator(s) <br /> Numb Pesticide Fest( s) ---- ----------------- <br /> --------------- ----------- FCO Grower <br /> 1051 SEVIN LARVAE Liquid Ground PCO Grower <br /> Liquid Ground <br /> 3831 LANNNATE LARVAE PCO Grower <br /> 16011 PARAQUAT WEEDS Liquid Ground <br /> Non-Ag Use: <br /> Conditions: PZ <br /> o awop <br /> ` <br /> ve me from liability for any damaa <br /> I understand that this permit does not relie <br /> caused by the use of these pesticides. I waive any <br /> to persons or property <br /> claim of liability for damages against the County Department of Agriculttur <br /> r. based on the issuance of this permit . I further understand that this permit <br /> may be revoked when pesticides are used in conflict with the manufacturer' s <br /> labeling or in violation of applicable laws, regulations and specific <br /> conditions of this permit. I ale <br /> uthorize theiDepartmentlon at all of PesticideaRegulationTOr t`_. <br /> whenever an emergency exists, Y <br /> County Department of Agriculture of all areas treated or to be treated , s ore- <br /> acilities for pesticides or emptied containers and equipment used or to be <br /> ` 1 <br /> [Form PR-ENF�-725 (Rev . 07/92) Pesticide Enforcement Branch <br /> in the treatment. <br /> Permit Applicant: <br /> �(o nG� Sign : <br /> (\a 4er. - <br /> r Date: 3�Z0/D � <br /> Title : re t✓ <br /> L� Date: <br /> �. Issuing Officer : <br />