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RESTRICTED MATERIALS PERM" continued . . . . . Page#: 3 <br /> AGUER NABORI PROPERTIES Permit#: 39-02-3904929 <br /> ------------------------------------------------------------------ - <br /> WORKERS SAFETY SERIES ATTACHED <br /> ------------------------------------------------------------------------------- <br /> CX] A-1 through A-9 General Info. [_7 8-1 Cholinesterase Testing <br /> ----------------------------------------------------- <br /> ----PERMIT CONDITIONS ATTACHED <br /> L ---------------------- ----------------------------------------------- <br /> [X] P - General <br /> [_] 0 - Dicamba & Phenoxy Herbicides - Central Valley/Hazardous Area <br /> ` [_] R - Dicamba & Phenoxys - Special Hazardous Area <br /> C_] S - Metam Sodium (Vapam) <br /> [_7 T - Aldicarb ( Temik ) <br /> C_7 U - Endosulfan (Thiodan ) <br /> [_] V - Rice Pesticides Program <br /> C_] Molinate (Ordram) Worker Safety <br /> C_J Attachments 1-9: Molinate ( 1 ,6) thiobencarb (2,6,7) , carbofuran <br /> (3,6) , methylparathion (4,9) and malathion (voluntary : 5;8) <br /> C_7 W - Methyl Bromide <br /> C_7 Soil within greenhouses <br /> L C_] Commodity <br /> f_] Soil injection <br /> C_] Tarred potting soil <br /> L [_] Single tree site <br /> [_] X - Furadan chemigation of grapes <br /> [X] Z - Other <br /> ---------------- ---________ <br /> L <br /> ------------------- ------------------------------- - - <br /> PESTICIDE SALES: GROUNDWATER PROTECTION <br /> ------------------------------------------------------------------------------- <br /> The material I am purchasing will not be used in a Pesticide Management <br /> Zane (as described in Section 6602, Title 3, California Code of Reg- <br /> ulations) for agricultural , outdoor institutional or outdoor industrial <br /> use. <br /> C_] The material I am purchasing will be used in a Pesticide Management Zone <br /> (as described in Section 6802, Title 3, California Code of Regulations) <br /> for agricultural , outdoor institutional or outdoor industrial use and a <br /> copy of my restricted materials permit is attached . <br /> Material purchased : [_] Atrazine C_J Simazine C_] Bromacil <br /> C_7 Diuron C_] Prometon [_7 Bentazon <br /> I Certify under penalty of perjury that the foregoing statement is true, <br /> �. and that I will not apply any material listed in Section 6800(a) in any <br /> Pesticide Management Zone for agriculture, outdoor institutional or <br /> outdoor industrial uses except in accordance with a permit issued by the <br /> county agricultural commissioner or the director in a county in which <br /> r there is no commissioner. <br /> Purchas Date <br />