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SU0012167 SSCRPT
Environmental Health - Public
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SU0012167 SSCRPT
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Last modified
5/7/2020 11:35:40 AM
Creation date
9/6/2019 11:13:37 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0012167
PE
2622
FACILITY_NAME
PA-1900009
STREET_NUMBER
2430
Direction
N
STREET_NAME
MURRAY
STREET_TYPE
RD
City
LINDEN
Zip
95236-
APN
10510020
ENTERED_DATE
1/29/2019 12:00:00 AM
SITE_LOCATION
2430 N MURRAY RD
RECEIVED_DATE
2/7/2019 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\M\MURRAY\2430\PA-1900009\SU0012167\SURSUB RPT.PDF
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EHD - Public
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■®eb 26 00 09:19a P&M Farms 2099314183 P. <br /> ■ <br /> ■� <br /> LEI TTER OF EiUTI-ToItIZATION <br /> ' To: San Joaquin County Agricultural Commissioner <br /> 2101 E.Earhart Ave,Suite 100 <br /> Stockton, CA 95206 <br /> Fax: 209-953-6022 <br /> From:(y)to 4o oOPERATOR OPTHE PROPERTY <br /> (PRINT NAME) <br /> PER'dITN.4A1E 0 D Z <br /> v . r <br /> P,DDRESS <br /> CITY STATE,Z P <br /> PHONE <br /> The authorized representative named below may represent me in obtaining arestricted material <br /> t permit or Operator identification number for use in San Joaquin County. I understand that <br /> authorization does not relieve me of liability for violations of pesticide laws or regulation on my <br /> Cornprop rt This authorization shall remain in effect until I revoke it in writing to the Agricultural <br /> ' Comni' r. <br /> Signatur Date: <br /> tOPE ORO E PROPERTY <br /> Title: U •�� <br /> Authorized Representative: f-- <br /> ' PRINT NAME � <br /> I am the property operator's: errplo -ee• H <br /> Y , [ � rela 'tive; [ ] Employee PCA; [ other <br /> sEcltr <br /> �. I hereby certify that the information above is correct to the best of my-knowledge. I also <br /> understand that;in <br /> the event of violation of pesticide laws or regulations, I could be held liable <br /> either separately or ' eth r with h roperty operator. <br /> 1 S ignature: <br /> AUTHORIZED gPhone: <br /> EN"I'AT[VE <br /> ' <br /> .3 CCR 6420(a): "Pernrits or <br /> J` agricultural use of a restricted material shall be issued in the name <br /> of the operator of the property to be treated. The permittee 0 when allowed by the <br /> ' calrantissioner(emphasis added),the permittee's authorized representative or licensed pest <br /> control adviser, shall sigh the permit. The authorized representative or licensed pest control <br /> adviser-shall provide the commissioner wiih written documentation frofn the permittee to act on <br /> his/iter beha f" <br /> 3CCR 6000: "Operator ofthe property" means a person who owns the property and/or is <br /> ' legally entitled to possess or use the property through terins of a lease, rental contract, trust, or <br /> other management arrangement. <br /> GG o �r�(b WP <br /> ' Received Time Jan. 27. 2015 5:56PM No. 9228 <br />
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