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SAN Jt aAQ tN {'Ot? M' <br /> 18681:. HATf?LTON AVENUE <br /> STOCY-TON, CA <br /> i15s>'t(fii!'c•JIe�: {209k• '0k<+sOD 95w2rv0.c5a- <br /> Fax: (204)008.3336 ks- <br /> enc-yo^rad<ney <br /> rnf.?.an._ui:-/w.alg.ranun <br /> _ <br /> , _:3p� <br /> RESTRICTED NUTERLU.S PERI U <br /> COSTA INC.',DAN Permit Number; 39-05-39010776 <br /> 126 9 SPRING CRF:FK PR COU11ty District #: 1) <br /> RIl'ON. CA 95366" EYpu-atiolt Date: December 31, 2005 <br /> Etlective. Date.: Febniaryl'��5 <br /> DAN COSTA 1101ne Phone: (209)599-3567 <br /> 17608 E LOUISE k%T, Shop Plume: (209) 234-2004 <br /> ESC:AIX YN. C'A s ?0 lvtabile I'ttorta: (209)531-6135 <br /> FRY: (209) 234-2001 <br /> 1'-1nittee Type: Yrivnte Applicator NOI Methal of Subulission. <br /> Pentit Type: Seasonal Phone: X FWc >; Box: X <br /> Possession: Possession &Use In Person: X Modem: Web, x <br /> NOI required 24 hour, prior to application. <br /> ...z;nd ofpzrmit f:?r <br /> 4pa`f(fby:;i:p(11111F <br /> 'tand that tl, _..---1de5 not reIieeme frorn Ii'rbility fc T'any darnages to ark person. or o-operty caused – — <br /> ify,the nae of ties ._� !-4. !waive any clairna of Lability for darnagea againsi the i"ounty]±eparisnent of <br /> Jig•riculh�based n r t;:e i�sua^re of this permit. t fur-ther understand that,this pen it.may he revc,ke::t when <br /> pectic ides are aced it. _or, i._t wltri the rnanufaeturer's labeling or in violation of applicable laws,re tiaiions aril <br /> spec'ific rownbon, c,t mis per nit.. I author<-e inspection at all reasonable times and whenever an crnergenry eVcists <br /> r by the Departrnent of r esticide ReAilation or the i_'owity ?epat-trnent ofAiTicuuw e.of all wean treated or to be <br /> treated,atorage fac iii"ice f_:r pe__tieide� or emptier.(containers and equipment med or to be used in the treatrnent <br /> unn PP.-ENF-i-" ,;Rev. 07192)P-c!icicle Enforcernet-it Branch j <br /> Permit r~ipplicant:I&MSigtied:�/ JYQ �j <br /> (Please p�t�t, <br /> Title: AeQ11/f Issue Date: <br /> R <br /> 6tw�Itw <br /> Issiting,Office Issue Date: —1 C-ik) z UU\\ <br /> r <br />