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SAN JOAQUIN COUNTY <br /> 1868 E. HAZELTON AVENUE ZCOZ- <br /> STOCKTON, CA 95205 <br /> LOffice: ( 209 )468-3300 Recorder (NOI ) : ( 209)408-3300 FAX: ( 209 )468-333( <br /> RESTRICTED MATERIALS PERMIT Permit# : 39-02-3903265 <br /> County HQ District# : C <br /> WOLTJER, LARRY Expiration Date : 12/31/2002 <br /> 15821 S SEXTONr Effective Date 7-MO <br /> LLARRY <br /> ESCALON, CA 95320- <br /> LARRY WOLTJER Home : ( 209 )838-343- <br /> 15821 S SEXTON Shop: ( ) <br /> ESCALON, CA 95320- Fax: <br /> Mobile : ( ) - <br /> ` Permittee Type Permit Type Possession NOI Method of Submission <br /> -------------- ------------ -------------- -------------------------- <br /> Private App [X] Seasonal [X] Puss & Use [X] Phone [X] Fax [X] <br /> Q A Cert [ ] Job [ ] Puss Only [ ] Box [X] Modem [ ] <br /> Ag PCO [ ] In Person [X] <br /> Non-Ag [ ] NOI required 24 hours prior to applicatioi <br /> Numb- Pesticide Pest( s ) Form. Method( s ) Applicator( s ) <br /> ----- --------------- ------------ -------- ---------------- ----------------- <br /> 1051 SEVIN LARVAE Liquid Air Ground PCO Grower <br /> 1061 FURADAN NEMATODE Liquid Air Ground PCO Grower <br /> 1360 CHLOROPICRIN NEMATODE Fumigant Ground PCO Grower <br /> 3141 GUTHION MITES Liquid Air Ground PCO Grower <br /> 3830 METHOMYL LARVAE Liquid Air Ground PCO Grower <br /> ,. 3850 METHYL BROMIDE SOIL/STORED Fumigant Ground PCO Grower <br /> 4840 ALUMINUM PHOSPH RODENTS Fumigant Ground PCO Grower <br /> 5540 STRYCHNINE GOPHERS Bait Ground PCC Grower <br /> 8041 2 , 4-DB WEEDS Liquid Air Ground PCO Grower <br /> ` 9801 2 , 4-D AMINE WEEDS Liquid Ground PCO Grower <br /> ****** PESTICIDES CONTINUED ON NEXT PAGE ****** <br /> Non-Ag Use : <br /> Conditions : PQW <br /> - --------------------------------------------------------------- <br /> I understand that this permit does not relieve me from liability for any damag <br /> to persons or property caused by the use of these pesticides . I waive any <br /> claim of liability for damages against the County Department of Agriculture <br /> 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 authorize inspection at all reasonable times and <br /> Whenever an emergency exists , by the Department of Pesticide Regulation or the <br /> County Department of Agriculture of all areas treated or to be treated, storag <br /> facilities for pesticides or emptied containers and equipment used or to be us <br /> in the treatment . [Form PR-ENF-125 (Rev. 07/92 ) Pesticide Enfo 'cement 4ranchl <br /> Permit Applicant : Lo rel) (o 0 IT -er Sign: <br /> Title: Date : O <br /> Issuing Officer: ✓� �� Date : _ '�� <br />