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VESTRICTED MATERIALS PERMIT continued .. Page#: 4 <br /> 6ENSTRA FARMING Permit#: 39-01-3903245 <br /> ---------------------= <br /> --------------------------------------------------------- <br /> - - ---- -- ------ ------ - ----- ----------- - ----- <br /> -- _- --------WORKERS SAFETY SERIES ATTACHED <br /> ------- ------------------------------------------------ <br /> CX7 A-1 through A-9 General Info. L7 B-1 Cholinesterase Testing . <br /> -- ---- --------------------------------------------------- --- <br /> ------------------------------------------------------------------------------- <br /> ------------------------------------------------------------------------------- <br /> PERMIT CONDITIONS ATTACHED <br /> ---------------------- ------------------------------ <br /> [X] P - General <br /> [X] Q - Dicamba & Phenoxy Herbicides - Central Valley/Hazardous Area <br /> [_] R - Dicamba & Phenoxys - Special Hazardous Area <br /> L] S - Metam Sodium (Vapam) <br /> L] T - Aldicarb (Temik) <br /> L] U - Endosulfan (Thiodan) <br /> V - Rice .Pesticides Program <br /> L7 Molinate (Ordram) Worker Safety <br /> L] Attachments 1-9: Molinate (1,6) thiobencarb (2,6,7), carbofuran <br /> (3,6), methylparathion (4,9) and malathion (voluntary: 5,8) <br /> L[X] W - Methyl Bromide <br /> [-] Soil within, greenhouses <br /> L] Commodity <br /> [_J Soil injection <br /> L] Tarped potting soil <br /> Single tree site <br /> L[_] X - Furadan chemigation of grapes <br /> [X7 Z - Other <br /> ------------------------------------------------------------------------------- <br /> PESTICIDE SALES: GROUNDWATER PROTECTION <br /> -----------I---am p--urc---hasing--------will-----not-be------used--in- <br /> -a--Pesti--- --cide---Management------------------ <br /> L-f The material <br /> Zone (as described in Section 6802, Title 3, California Code of Reg- <br /> ulations) for agricultural, outdoor institutional or outdoor industrial <br /> use. <br /> L7 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: L7 Atrazine U Simazine [_] Bromacil <br /> 6 L7 Diuron [_] Prometon [_] 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 /> 1 county agricultural commissioner or the director in a county in which <br /> El• therref is no commissioner. ,6 <br /> --------Purchaser--------- Date <br /> L <br />