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SAN JOAQUIN COUNTY <br /> 1568 E . HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> r <br /> Web URL :www. co . san-joequin . ca . us/agcomm <br /> E-Mail : <br /> Office : (209 ) 468-3300 Recorder (NOI ) : ( 209 ) 468-3300 FAX: ( 209 ) 468-3330 <br /> RESTRICTED MATERIALS PERMITPERMIT # 39-02-3903214 <br /> County HQ District # : C <br /> r <br /> SCHULTZ, VERNE Expiration Date : 12/31/2002 <br /> 31146 E LONE TREE RD Effective Date <br /> ` OAf+',DALE, CA 35361- a.- ;ZD01 <br /> VERNE SCHULTZ Home : ( 209 ) 847-0516 <br /> 31146 E LONE TREE RD Shop: <br /> OAKDALE, CA 95361- Fax: <br /> Mobile : ( 209 )606-7959 <br /> ------------------------------------- ---_____ <br /> Permittee Type Permit Type Possession NOI Method of Submission <br /> -------------- ------------ -------------- -------------------------- <br /> �mPrivate App IXI Seasonal AXI Foss & Use IXI Phone IXI Fax IXI <br /> Q A Cert I ,lob I Poss Only 11 Box I I Modem 11 <br /> Ag POO I I In Person IXI Web IX) <br /> Non-Ag I I NOI required 24 hours prior to application <br /> ------------------------------------------------------------------------------- <br /> Non-Ag Use : None. <br /> Conditions : PQVZ <br /> ------------------------------------------------------------------------------- <br /> ------------------------------------------------------------------------------- <br /> �I understand that this permit does not relieve me from liability for any damage <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 /> r.County Department of Agriculture of all areas treated or to be treated , storage <br /> facilities for pesticides or emptied containers and equipment used or to be used <br /> in the treatment . (Form PR-EI-IF-125 (/Rev./07/92 ) Pesticide Enforcement Br i <br /> Permit Applicant : - ! � 2GG�= ��- Sign : ' <br /> Title: Issue Date : <br /> 6. <br /> Issuing Offices : % Issue Date : <br /> Page 7 <br /> r <br /> V <br />