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SU0006957 SSCRPT
Environmental Health - Public
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SU0006957 SSCRPT
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Last modified
5/7/2020 11:32:49 AM
Creation date
9/6/2019 10:40:37 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0006957
PE
2622
FACILITY_NAME
PA-0800028
STREET_NUMBER
6686
Direction
W
STREET_NAME
KILE
STREET_TYPE
RD
City
LODI
APN
01112002
ENTERED_DATE
2/7/2008 12:00:00 AM
SITE_LOCATION
6686 W KILE RD
RECEIVED_DATE
2/6/2008 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\K\KILE\6686\PA-0800028\SU0006957\SSC RPT.PDF
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EHD - Public
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St'iJ.v` ?OAQITIN e0V NT l� - <br /> 1868 E. HA2-g1TON AVr.NTjE <br /> STOCKTON, CA 95205- <br /> E-mal: '3�+�:w1+.B.cc.san•iceuran.ca::tag-toms <br /> Office: -(iO4)46S•',300 Fax: (20M462-3330 Recorder NO-Ps):(209'�?60-3300 <br /> RESTRICTED IMATERIAIS PEItx'�IIT <br /> DEN HARTOG IN1"L FARINIS Permit Number: 39-09-3904634 <br /> 7497 W KILE RD coomw District# G <br /> L•ODI,CA 95242- Expuntion Dote: December"sl,2009 <br /> r Effective Date: 1p9J <br /> Jar1U�r� 'ir a06 <br /> PIE'PIIt DEN HARTOG Home Phone: (209)794-2542 <br /> 7497 W KII.E RD Shop Phone: ( ) - <br /> LODI,CA 95242- Mobile Phone: (209)915-1329 <br /> Fax: (209)794-0608 <br /> Permittee Type: Private Applicator NOI Method of Submissioa: <br /> Permit Type: Seasonal Phone: X Fac: X Pox: <br /> Possession: Possession Only In Person: X Modem: Web: x <br /> NOI required 24 hours prior to application. <br /> Conditions: A.P.W <br /> See end ofpe®itfee <br /> code descriptio <br /> ---------------------------------------------- <br /> I understand that this permit does not relieve me from liability for any damages to any persons or propety caused <br /> by the use of these pesticides. I wive any claims of liability for damages against the County Department of <br /> Agriculture based on the issuance of this permit I ftu-diw uidera<and that this permit may be re c*ed when <br /> pesticides are used in conflict with the manufaduer's labeling or in violation of applicable laws,regulations and <br /> specific conditions of thus pernit I authorize inspection at all reasonable time;and whenever an ernergency exist: <br /> by the Department of Pesticide Regulation or the County Department of Agriculture of all areas treated or to be <br /> treated,&w age facilities for pesticides or emptied containers and equipment used A to be used in the treatment. <br /> [Form PR-EMF-125 (Rehr. 07!92)pesticide Fxnfo•cement Branch) <br /> 101 <br /> / L <br /> Petxrtit Applic Signed / —(/�,2y <br /> esse Print) <br /> Title: Issue Date: <br /> (Please Punt) <br /> yyn��,, <br /> Issuing Officer.YiGI(� t�{ LIGE Issue Date: (a t f 0 ' <br />
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