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SU0007634 SSCRPT
Environmental Health - Public
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SU0007634 SSCRPT
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Last modified
5/7/2020 11:33:09 AM
Creation date
9/6/2019 11:01:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0007634
PE
2622
FACILITY_NAME
PA-0900051
STREET_NUMBER
17155
Direction
E
STREET_NAME
LONE TREE
STREET_TYPE
RD
City
ESCALON
APN
20320018
ENTERED_DATE
3/16/2009 12:00:00 AM
SITE_LOCATION
17155 E LONE TREE RD
RECEIVED_DATE
3/13/2009 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\L\LONE TREE\17155\PA-0900051\SU0007634\SSC RPT.PDF
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EHD - Public
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SAN JOAQUIN COUNTY <br /> 1868 E. HAZELTON AVENUE <br /> STOCKTON, CA 95205- <br /> lVeb:www.co.san-ioaquin.ca.u,12ge mm <br /> Office: (209)468.3300 Fax: (209)468.3330 Recorder(Nope): (209)568.3300 <br /> RESTRICTED MATERIALS PERMIT <br /> COSTA INC,DAN Perm it Number; 39-08-3901076 <br /> 1269 SPRING GREEK DR Comity District#: B <br /> RIPON, CA 95366- Expiration Date: December 31, 2008 <br /> Effective Date: <br /> DAN R COSTA Home Phone: (209)599-3563 <br /> 17608 E LOUISE AVE Shop Mone: (209) 234-2004 <br /> ESCALON, CA 95320 Mobile Phone: (209)531-6135 <br /> Fax: (209) 234-2001 <br /> Pemlittee TWe: Private Applicator NOI Method of Submission: <br /> Pemut 1',pe: Seasonal Phone: X Fax: X Box: X <br /> Possession: Possession & Use In Petson: X Web:Y Modeny <br /> 1NOI required 24 hon mior to application. <br /> Conditions: AP,(,) <br /> See end of permit for <br /> ^.ode desmpbons. <br /> ——————— —————————————————————— ————————— ———————— <br /> I understand that this permit does not relieve me from liability for any damages to any pe-sons or propNerty caused <br /> by tlne use of the-s4-pesticides. I waive airy claims of liability for damages against.the County Depattmeot of <br /> Agricvluure based on the issuance of this permit. I further understand that this permit may be revoked when <br /> pesticides are used in conflict with the manufacturer's labeling or in violation of applicable laws,regulations atnd <br /> vecific conditions of this permit. I audwrize inspection at all reasonable times and whenever an emergency exists <br /> by the Departmentof Pesticide Regulation or the County Deportment of Agriculture of all areas treated or to be <br /> treated,stooge facilities for pesticides or emptied containers and equipnnent used or to be used in the treat neat. <br /> I have considered alternatives and nnitigation measures pursuant to Title 3,California Code of Regulations,section 642£; <br /> Taking into account ec olanir_,environmental,social, and teedunological factors,I have adopted those that are feasible <br /> and would substantially lessen any significant adverse inacvirzan <br /> [Form PR-F.NF-125 (Rev. 11/06)PeoUcide EnforcemmtBrnnc _ <br /> PetntitApplican�o�. �� <br /> (Flease Rini) Issue Date: <br /> —M e�nt) <br /> Issuing Officer_ Issue Date: <br /> e <br />
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