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RESTRICTED MATERIALS PERMIT -continued � <br /> PEZZI ORCHARDS Permit#: 39-i? - 9z' <br /> ------- <br /> WORKERS SAFETY SERIES ATTACHED <br /> ------------------------------------------------------------------------------------ <br /> � [X] A.-1 through A-9 General Info. [_� B--1 Cholinesterase Testing <br /> .F'EP:IV I T GOND I T I Ol�S <br /> v - ATTACHED <br /> [X; `..' -- Dica,'^b{-c & P'hcn,oxy H4r-bi tides - Central v.:.ti ;'y, rti.:ctrdo LtS A -QG <br /> [_ � r Dicamba & Pheno:.y's Sped l !"e.:a-zardous Area <br /> S Metam Sodium (Vzipam) <br /> Aldicarb (Tem' k ) <br /> U -... EndOSLIlfan (Th:Qd an <br /> V Rice Pesticides Program <br /> _ [_; Molinate (Ordram) Worker Safety <br /> Attachments 1--9: Molinate ( 1 ,6) thiobencarb (2,6,7) , carbofuran <br /> (3,6) , methylparathion (499) and malathion (voluntary: 5,S) <br /> [X] W - Methyl Bromide <br /> Soil within greenhouses <br /> Commodity <br /> [_, Soil injection <br /> [_� Tarped potting soil <br /> - Single tree site <br /> [_I X uradan chemigation of grapes <br /> ;.X; Z - Other <br /> PESTICIDE SALES: GROUNDWATER PROTECTION <br /> +,> , The-material I am purchasing will not be used in a Pesticide Management <br /> Zane (as described in Section 6802, Title 3, California Code of Reg- <br /> ulatiunS) for agricultural , outdoor. institutional or outdoor industrial <br /> use. <br /> [_] 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: C_; Atrazine C_7 Simazine C_? Promaci.l <br /> [_] Diuron C_3 Prometon [_i BentazQ;� <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 6200(a) in any <br /> `-''esticide Management Zone for agriCUIture, outdoor institutional Cr <br /> outdoor industrial uses exceDl- J n accordance with a per.-i-nit iss._iad by the <br /> C�Lii: j' -i- -i Cu..tui �� _.._.- -. .,� _ - _. Com[: j' _. .1. ._-. . <br /> ere no commissioner. <br /> 02 - o r <br /> r. <br />