Laserfiche WebLink
Page#: 1 of <br /> nestricte.d MaterialsPeri Conditions <br /> rnl A y' g t=:onditions Apply To - . _ . _ _ _ . _ . . . Permit#: 39-02-39033-1t-' <br /> -------------------- <br /> WOR.uERS SAFETY SERIES ATTAt:HED <br /> ------------------------------------------------------------------ <br /> [ ;] A-1 through A-9 General Info. C_J B-1 01 olinesterase Testing <br /> =--------------------- ---- <br /> ----c ERMIT COFDITIONS AT T ACEED <br /> - --------------------------------------------------------- <br /> [>;J P - general <br /> [YJ Q - Dicamba Phenoxy Herbicides - Central 'Valley Hazardo ua Area <br /> [_J - iii-ca,nba fir. Phelio .y-- - Special I1az ardouc Are, <br /> [_J - 1�8taii2 Sodium & Metam Potassium <br /> - Aldicarb (Temi'+f) <br /> [_J Li - Endosulfan (Thiodan) <br /> [_J t' - Mice Pesticides Program <br /> [_J Molinate (Ordram) Worker Safety <br /> [_] A-tachtaients 1-9. Molinate i I- 6) t.hiobe :car-b (2,c;,r ) , arl;L%i;ir'a <br /> (3,6) , methylparat.hion (4.9) and ma-lathion (,voluntary-. <br /> FI 7 V1 - Methyl Bromide <br /> [_J =.oil within greenhouses <br /> =_J Commodity <br /> E_7 moil injection <br /> F J Tarped potting soil <br /> [_Single tree site <br /> F--! X - Furadan chemigation of grapes <br /> 1XJ Z - Other <br /> ---------- <br /> ------------------------------------------ <br /> PESTICIDE SALES: GROUNDWATER PRI;TECTIOI0; <br /> ------------------------------------------------------------ <br /> [,�; The material I atm purchasing will not be used in a Pesticide Manageiient <br /> Zone (as described in Section 6802, Title 3, California Code of Reg- <br /> ulations) for agricultural, outdoor institutional or outdoor industrial <br /> - <br /> Th-- neat-rial I e_m purchasing will be used in a Pesticide Manaaem—ent. 2 ne <br /> (ate describe._ 4.1-3 Section 6802, Title >, Vali foriiia Cod`` of Reggulations) <br /> for arricultur al , outdoor institutional or outdoor industrial use and a <br /> copy of my restricted materials permit, is at_•aciie�� <br /> Material purchased: [_] Atrazine [_7 Simazine [_] Brociacil <br /> [_J Diuron [_J zirometon [_J Bentazon <br /> I Certify under penalty of perjury that the foregoing statement is try e, <br /> and t", at I will not apply any material listed in Section 6800(a) in ---ny <br /> Pe-sticide Management Zone for agriculture, outdoor institutional or T <br /> outdoor industrial uses eXcer-t in accordance with a permit Hued by taLe <br /> co7irtagricultural c.ommi sioner or the director in a county in crhs.c1 <br /> 1 <br /> Dat-- <br /> Purchaser <br />